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NCERT Class 6 Science Chapter 11 Air Around Us Question And Answers

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NCERT Class 6 Science Chapter 11 Air Around Us Long Question And Answers

Question 1. How will you show that air is dissolved in water?
Answer:

Take some water in a glass vessel or beaker. Heat it slowly on a tripod stand well before the water begins to boil. Look carefully at the inner surface ofthe vessel, you will see tiny bubbles inside. These bubbles come from the air dissolved in water

Class 6 Science Chapter 11 Air Around Us Water Contains Air

Question 2. Observe the figure given below depicting the distribution of some components present In air and answer the following questions:

Read and Learn More Class 6 Science Question And Answers

Class 6 Science Chapter 11 Air Around Us Depicting Distribution Some Components

  1. Identify all the components.
  2. What purpose is served by the component
  3. Do the values or percentages of these components vary?

Answer:

1.

  1. Nitrogen  – 78%
  2. Oxygen – 21%
  3. CO2, water vapour-  0.03%
  4. Other gases and dust particles – 1%

2. The component is oxygen. It is used by humans and animals for respiration. It also helps in combustion/ burning.

3. Yes, the composition ofair is not always the same. It changes slightly from place to place.

Question 3. Explain the following observations briefly.

  1. A firkin does not rotate in a closed area
  2. The arrow of weather cock points towards a particular direction at a particular moment
  3. An empty glass Is not empty
  4. Breathing through the mouth may harm you

Answer:

  • Motion offers are based on the pressure/force applied by air on the blades of the first. A firkin does not rotate in a closed area because of a lack of air movement.
  • The arrow of the weather cock points towards a particular direction as it shows the direction in which the air is moving at that place at a particular moment.
  • An empty glass in feet is not empty. It is filled with air. Which is present everywhere.
  • Breathing through the mouth may harm us because we may inhale dust,f present in the air which is harmful

Question 4. Pahell kept some water In a beaker for heating. She observed that tiny bubbles appeared before the water started to boil. She boiled the water for about 5 min filled It In a bottle upto the brim and kept the bottle airtight till cooled down to room temperature.

  1. Why did the tiny bubbles appear?
  2. Do you think tiny bubbles will appear on heating the water taken out from the bottle? Justify your

Answer:

  1. Air is dissolved in water in the form of oxygen. Tiny bubbles appear when air present in the water escapes from boiling it.
  2. No, tiny bubbles will not appear again as there is no dissolved air in this water after boiling.

Question 5. Explain what makes the carbon dioxide gas present in the air necessary for all in the atmosphere.
Answer:

The presence of small amount of carbon dioxide gas in the atmosphere is essential for the growth and existence of living beings.

  • The desirable proportion of carbon dioxide in the atmosphere is 0.03%.
  • The importance of carbon dioxide in the atmosphere is as follows
  • It leads to the heating of the Earth and its atmosphere which is essential for our survival
  • It takes part in the photosynthesis process carried out by green plants to prepare their food

NCERT Class 6 Science Chapter 11 Air Around Us Question And Answers

Question 6. Write a few sentences for an imaginary situation if any of the following gases disappear from the atmosphere.

  1. Oxygen
  2. Nitrogen
  3. Carbon dioxide

Answer:

  1. There will be no life on the Earth. Oxygen is vital for life. It helps in burning, respiration, photosynthesis, etc. Oxygen is a basic need of all living beings.
  2. Nitrogen is utilised by plants for their growth and development in the absence of nitrogen no plants will survive and hence, no life is possible on Earth.
  3. Carbon dioxide is needed for photosynthesis which occurs in green plants. In its absence, plants will not be able to prepare their food and hence, there will be no life on the Earth.

Question 7. Humans and animals use oxygen for respiration and plants require carbon dioxide for photosynthesis. How are these two processes related?
Answer:

  • Humans and animals use oxygen present in the environment to carry out respiration and release CO2 as a byproduct of this process.
  • Plants perform photosynthesis by using this CO2  present in the atmosphere accumulated due to the activities of humans and animals. They release oxygen as a byproduct which also gets out in the atmosphere.
  • Plants depend on humans and the activities performed by them like burning of fuels, etc. for CO2 and humans depend on plants for a continuous oxygen supply. Thus, these two processes maintain a unique balance between O2 and CO2  concentration in our environment

Question 8. Which of these actions can cause air pollution? Circle ‘Yes’ or ‘No’ for the correct response

Class 6 Science Chapter 11 Air Around Us Air Pollution Of Circle Yes Or No

Answer: 

  1. No
  2. Yes
  3. No

Question 9. Observe the given figure and answer the following question?

Class 6 Science Chapter 11 Air Around Us Covering Nose And Mouth Of The Policeman

  1. What Is covering the nose and mouth of the policeman?
  2. Why is he putting a cover on his nose?
  3. Can you comment on the air quality of the place as shown in the figure

Answer:

  1. The mask covers the nose and mouth of the policeman.
  2.  The policeman is putting a cover on his nose to himself from dirt/polluted air produced by vehicles on the road.
  3. The air quality of the place is not good. It is due to the smoke and gases emitted by the automobiles along with dust particles present in the air

NCERT Class 6 Science Chapter 11 Air Around Us Short Question And Answers

Question 1. What should Sumit keep the same for the activity? Circle ‘Yes’ or ‘No’ for the correct response.

Class 6 Science Chapter 11 Air Around Us Circle Yes Or No

Answer:

  1. Yes
  2. No

Question 2. Make sentences using the given set of words.

  1. 99%, oxygen, nitrogen, and air, together
  2. Respiration, dissolved, animals, air, aquatic
  3. Air, wind, motion, called

Answer:

The correct sentences are:

  1. Oxygen and nitrogen together make up 99% ofthe air.
  2. Aquatic animals use dissolved air for respiration.
  3. Air in motion is called wind.

Question 3. Ravi fills a steel vessel with water and starts heating it in an oven. He notices small bubbles at the bottom of the vessel after some time.

Class 6 Science Chapter 11 Air Around Us Small Bubbles At Teh Bottom Of The Vessel

Question 4. Identify the major components of air present in the

  1. Inhaled air
  2. Exhaled air

Answer:

  1. Oxygen
  2. Carbon dioxide

Question 5. How does air play an important role in the water cycle?
Answer:

  1. The water vapour from lakes and sea after evaporation is carried into the atmosphere by air.
  2. Here, it gets condensed and finally falls back on Earth as a ram. And this cycle continues.

Question 6. Why does a lump of cotton wool shrink in water?
Answer:

  • Lump of cotton wool has air among gaps of cotton fibres.
  • When dipped in water, air from these gaps is replaced by water.
  • The cotton lump becomes heavy and also shrinks due to the removal of air gaps.

Question 7. Why do mountaineers carry oxygen cylinders while climbing high mountains?
Answer:

  • As we go higher in the atmosphere, the air gets rarer, consequently, oxygen is also reduced.
  • This is why oxygen cylinders are carried by mountaineers, to be able to breathe in a lack of oxygen.

Question 8. The transparent glass of windows appers hazy if not wiped why? 
Answer:

  • Dust particles sit on the surface ofthe glass windows.
  • Other components in the air such as moisture (water vapours) also get collected and the window appears hazy.

Question 9.  How do plants and animals help each other in the exchange of gases in the atmosphere?
Answer:

  • There is an interdependence of plants and animals on each other for the exchange of gases.
  • Plants take carbon dioxide and give out oxygen to the atmosphere.
  • Animals inhale this oxygen and give out carbon dioxide to the atmosphere.
  • Therefore, plants and animals help each other in the exchange of gases in the atmosphere.

Question 10. Air takes the shape, smell, etc. of the object/ place it is present in. Explain?
Answer:

  1. Air does not have a fixed shape or size of its own because it is a gaseous mixture whose particles are very loose, thus not able to form a fixed shape
  2. If air is blown in a balloon of a round shape, it takes its shape. Similarly, air can be enclosed in packets of chips different in shape and size.
  3. Like water, air also has no smell. It carries the odour of whatever is present in the surroundings. We can smell a nice perfume or a bad smell because air carries the smell.

Question 11. When an empty glass bottle is inverted and inserted into a trough filled with water, water does not enter the bottle. Specify.
Answer:

Water does not enter into an inverted glass bottle because even when the bottle appears empty, it’s not. Air is present inside the bottle or any other area which is empty.

All the space in the bottle is occupied by air. This air prevents the water from entering inside the bottle. As we tilt the bottle, air present inside moves out. As air comes out, the space becomes empty allowing the entry of water. The space vacated by leaving ofair is then occupied by water.

Question 12. During any fire incident, it is advised to

  1. Wrap a towel or woollen blanket over the burning object.
  2. Use a fire extinguisher to stop the fire.

Why are these methods advised? Give reasons.
Answer:

  • Fire or burning is supported by oxygen. To stop it, The towel or woollen blanket used cuts off the supply of oxygen, which supports burning. As this supply is cut out, the fire eventually stops.
  • A fire extinguisher contains carbon dioxide gas, which does not support burning. So, when a fire extinguisher is used over the area, CO2 cuts off the oxygen supply from the air causing the fire to be extinguished

Question 13. Garima observed that when she left her tightly capped bottle full of water In the open sunlight, tiny bubbles formed all around inside the bottle. Help Garima to know why It so happened. 

Air is dissolved in water in the form of oxygen. When a water bottle is left in the open sunlight, tiny bubbles form all around inside the bottle because air dissolved in water starts escaping in the form of tiny bubbles due to heat from the Sun.

Question 14. On a Sunday morning, Paheli’s friend visited her home. She wanted to see some flowering plants in the nearby garden. Both of them went to the garden. While returning from the garden, they also observed some flowering plants on the roadside. But to their surprise, they found that the leaves and flowers of these roadside plants were comparatively very dull. Can you help them to know why?
Answer:

The leaves and flowers of the roadside plants are very dull because the air along the roadside is polluted with air pollutants due to emissions of harmful gases and dust particles from vehicles and industries, etc. Thus, the roadside plants had probably some dust and soot deposited on them. This made them appear dull

Question 15. Why is it safer to breathe through the nose than through the mouth?
Answer:

  1. Fine hair and mucus are present in our nostrils.
  2. They prevent the dust particles from entering the respiratory system.
  3. Hence, it is safer to breathe through the nose than through the mouth.

 

NCERT Class 6 Science Chapter 11 Air Around Us Very Short Questions and Answers

Question 1. What do you have in your fist when you close it?
Answer:  Though we might think, there is nothing, when we close our fists, air gets trapped in the spaces between our fingers.

Question 2. What kind of a mixture is air?
Answer:  Air is a mixture of many gases. The major components ofair are gases like oxygen, nitrogen, etc water vapour and dust

Question 3. Why does a policeman wear a mask, while regulating traffic?
Answer: There are so many dust particles in the air in crowded traffic. A mask protects the respiratory system ofthe policemen

Question 4. Why during an accident or fire, one is advised to wrap a woollen blanket over a burning object?
Answer: By wrapping the object with the woollen blanket, the oxygen supply is cut off and the fire gets extinguished.

Question 5. Will the tiny air bubbles seen before water boil, also appear if we do this activity by reheating boiled water kept in an airtight bottle? 
Answer: If boiled water kept in an airtight container is reheated, the bubbles do not appear again as dissolved air is already escaped while heating before.

Question 6. We say that air Is present everywhere. Have you ever seen it? what makes you say so?
Answer: No. air cannot be seen, but it can be felt during wind, fluttering ofleaves, etc.

Question 7. A place where no air is present will be called what? Give example.
Answer: A place without air is called a vacuum,

Example:  Space.

Question 8. Oxygen occupies how many parts of the air?
Answer: Oxygen occupies about l/5th part ofthe air.

Question 9. Oxygen and nitrogen form 99% of the air. Rest 1% is constituted by which components?
Answer:  1% of air includes carbon dioxide (CO2), water vapours, helium, hydrogen, dust particles and smoke.

Question 10. Do you know the reason why mountaineers carry oxygen cylinders with them?
Answer:  As we go up above the sea level, oxygen decreases at higher altitudes which causes breathing problems. So mountaineers carry oxygen cylinders with them.

Question 11. Is air necessary for burning? Give a reason for your answer.
Answer: Yes. because oxygen present in the air supports burning.

Question 12. Gases are present in certain ratios in the air. Can you tell the relative proportions of nitrogen and oxygen in the air?
Answer:  Nitrogen and oxygen are present in the ratio of 4:1 by volume in air.

Question 13. Name the major part of air that does not support burning.
Answer:  Nitrogen is the major part of the air which does not support burning.

Question 14. Name the sources of carbon dioxide in the air.
Answer:  Respiration by animals and plants and the burning of fuel etc. are the sources of carbon dioxide.

Question 15. During rainfall, the spaces between soil particles are filled with water. How do the organisms of soil breathe?
Answer:  Organisms present in soil come out of their holes and burrows for breathing.

Question 16. Give a reason why factories have tall chimneys.
Answer: Tall chimneys take the smoke produced by factories high up in the air to reduce harmful effects on the ground.

Question 17. In many musical instruments, air plays an important role. Can you name such instruments?r
Answer: Air plays an important role in several musical instruments such as the flute, trumpet, harmonium, etc.

Question 18. Traffic policemen use the masks for which reason?
Answer: To prevent inhalation of smoke given out by automobiles, traffic policemen use masks

Question 19. Which gas in the atmosphere is essential for respiration?
Answer: Oxygen is essential for respiration.

Question 20. The layer of air around the Earth is known as
Answer: Atmosphere

Question 21.  The component of air used by green plants to make their food is
Answer: Carbon dioxide

Question 22.  Where do the bubbles come from?
Answer: Air is dissolved in water. When water is heated, the air escapes. Hence, the bubbles form

NCERT Class 6 Science Chapter 11 Air Around Us Fill In The Blanks

Question 1. As we move higher in the atmosphere, the air gets ________________
Answer: Rarer

Question 2. Aquatic animals use dissolved ________________ in water for respiration
Answer: Oxygen
.
Question 3. The component of air used by green plants to make their food is________________
Answer:  Carbon dioxide

Question 4.________________in factories take the harmful smoke and gases away from our noses.
Answer: Chimneys

Question 5. Windmills are used to generate ________________
Answer: Electricity

Question 6. The________________ particles can be seen moving in a beam of sunlight in a dark room.
Answer: Dust

Question 7. The envelope of air that surrounds the Earth is called ________________
Answer: Atmosphere

Question 8. The presence of ________________in air is important for the water cycle in nature
Answer: Water vapours

NCERT Class 6 Science Chapter 11 Air Around Us True/False

Question 1. Air helps in the movements of sailing yachts and gliders, but plays no role in the flight of birds and aeroplanes
Answer: False

Air also helps in the (light of birds and aeroplanes

Question 2. The composition of air is always the same.
Answer: False

The composition ofair is not always the same.

Question 3. Respiration can occur only in the presence of nitrogen
Answer: False

Nitrogen has no role in the process of respiration

Question 4. Nitrogen present in the air supports the process of burning.
Answer: False

Nitrogen does not support the process of burning

Question 5. Green plants need carbon dioxide gas to make food.
Answer: True

Question 6. Plants produce oxygen during the process of making their food.
Answer: True

Question 7. Aquatic animals and plants use dissolved nitrogen to survive in water.
Answer: False

Question 8. The amount of air increases as we go up.
Answer: False

Question 9. CO2 is important for green plants.
Answer: True

NCERT Class 6 Science Chapter 11 Air Around Us Assertion-Reason Questions

The following questions consist of two statements. Assertion and Reason (R). Answer these question by selecting the appropriate option given below

  1. Both A and R are true and R is the correct explanation of A
  2. Both A and R are true, but R is not the correct explanation of A
  3. A is true, but R is false
  4. A is false, but R is true

Question 1.

Assertion (A): Carbon dioxide and oxygen are involved in respiration.

Reason (R): The plants and animals consume carbon dioxide and oxygen respectively 

Answer: 1. Both A and R are true and R is the correct explanation of A

Question 2.

Assertion (A): We feel comfortable on a windy day.

Reason (R): Wind is caused by the movement of air.

Answer: 2. Both A and R are true, but R is not the correct explanation of A

Both A and R are true, but R is not the correct. explanation of A. The correct explanation is that The movement ofair causes wind, but it does not explain why we feel comfortable on a windy day. We feel comfortable because the moving air helps in the evaporation of sweat from our body thereby giving us a cooling effect

Question 3.

Assertion (A):  Plants release carbon dioxide into the atmosphere.

Reason (R):  Plants make their food by the process of photosynthesis.

Answer: 4. A is false, but R is true

A is false, but R is true. This can be corrected as Plants release oxygen into the atmosphere and they consume carbon dioxide during photosynthesis.

Question 4.

Assertion (A):  Tire pressure of air decreases with height.

Reason (R):  Tire amount of air decreases as we go up

Answer: 1. Both A and R are true and R is the correct explanation of A

Question 5.

Assertion (A): Plants can absorb nitrogen in the form of nitrates.

Reason (R): Plants cannot use nitrogen directly from air.

Answer: 1. Both A and R are true and R is the correct explanation of A

Question 6.

Assertion (A): Bubbles form when soil is added to water.

Reason (R):  Air is dissolved in soil

Answer: 1. Both A and R are true and R is the correct explanation of A

NCERT Class 6 Science Chapter 11 Air Around Us Match The Columns

Question 1. Match the Column 1 with Column 2

Class 6 Science Chapter 11 Air Around Us Match The Column 1 And 2

Answer: 1-D, 2- C, 3- E, 4- A, 5- B

Question 2. Match the Column 1 with Column 2

Class 6 Science Chapter 11 Air Around Us Match The Column 1 And 2.

Answer: 1-D, 2- E, 3- A, 4- B, 5- C

Question 3. Match the Column 1 with Column 2

Class 6 Science Chapter 11 Air Around Us Match The Column 1 And 2..

Answer: 1-E, 2- D, 3- A, 4- B, 5- C

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Question And Answers

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NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Long Question And Answers

Question 1. Arrange the following lengths in their increasing magnitude 1 metre, 1 centimetre, 1 kilometre, 1 millimetre
Answer:

We know that,

1 kilometre (km) = 1000 metre (m)

1 metre (m) = 100 centimetre (cm)

1 centimetre (cm) = 10 millimetre (mm)

Hence, the increasing order of given units is as follows 1 millimetre <1 centimetre <1 metre <1 kilometre

Question 2. The height of a person is 1.65 m. Express it Into cm and mm.
Answer:

Given, the height of a person = 1.65 m

We know that,

1 metre (m)= 100 centimetre (cm)

1 metre (m)- 1000 millimetre (mm)

The height of a person in cm

= 1.65 × 100 cm = 165 cm

Read and Learn More Class 6 Science Question And Answers

The height of a person in mm

= 1.65 × 1000 mm = 1650 mm

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Questions And Answers

Question 3. The distance between Radha’s home and her school is 3250 m. Express this distance into km.
Answer:

Given, the distance between Radha’s home and her school = 3250 m

We know that,

1 km = 1000 machine

1 m = \(\frac{1}{1000}\) km

Now, the distance between Radha’s home and her school in km

3250 × \(\frac{1}{1000}\)

= \(\frac{3250}{1000}\)

= 3.25 km

Question 4. While measuring the length of a knitting needle, the reading of the scale at one end is 3 cm and at the other end is 33.1 cm. What is the length of the needle?
Answer:

Accurate scale reading begins from zero as shown below

Class 6 Science Chapter 7 Motion And Measurement Of Distances Accurate Scale

But here the reading on the scale begins with 3 cm

Thus, the error in the scale

= 3 cm- 0 cm = 3 cm

Now, the other end on the scale reads = 33.1 cm

Thus, the actual length of the needle = (Reading on the other end Error reading of the first end)

= 33.1 cm – 3 cm = 30.1 cm

Question 5. Write the similarities and differences between the motion of a bicycle and a ceiling fan that has been switched ON.
Ans.

Similarities are given below

  • The wheels of a bicycle and a ceding fan execute a rotational motion on a fixed axis.
  • The particles of both exhibit circular motion except the particles at the centre.
  • Differences are given below
  • A bicycle changes its position while exhibiting circular motion but a ceiling fan does not change its position.
  • Bicycles can execute rectilinear motion with translational motion but ceiling fan do not execute rectilinear motion.

Question 6. It is not accurate to measure a length with elastic tapes. Explain why?
Answer:

Elastic tapes are stretchable and their length can be increased during the measurement if it is not handled with care. Therefore, the measurement done by elastic tapes may be greater than the actual length of the object. So, we can say that elastic tapes are not accurate for measuring a length.

Question 7. Three students measured the length of a corridor and reported their measurements. The values of their measurements were different. What could be the reason for the difference in their measurements? (Mention any three)
Answer:

The reasons may be as follows:

  • Their scales of measurement may not be standard or they may be using different scales of measurement.
  • The length of the scale may not be proper, i.e. the length of the scale may be shorter than the length they want to measure.
  • There may be some errors in the scale which they are using or they may not be using the correct method of observing the scale.

Question 8. While travelling in a train, it appears that the trees near the track are moving whereas co-passengers appear to be stationary. Explain the reason.
Answer:

While travelling, trees near the track seem to be moving back (i.e. opposite to the direction of motion of a train) because there is a relative motion between outside trees and the moving train. In the case of co-passengers, the relative motion between us and co-passengers is zero, so they appear to be stationary.

Question 9. The blades of a moving electric fan are different in the following ways:
Answer:

Class 6 Science Chapter 7 Motion And Measurement Of Distances Wheel Of A Moving Bicycle And Mark On The Blade
Question 10. Boojho was riding his bicycle along a straight road. He classified the motion of various parts of the bicycle as

  1. Rectilinear motion
  2. Circular motion and
  3. Both rectilinear as well as circular motion.

 Can you list one part of the bicycle for each type of motion? Support your answer with a reason:

  1. Rectilinear motion:  Rectilinear motion The handle of a bicycle will always move in a rectilinear path because it cannot do circular or rotatory motion.
  2. Circular motion: Circular motion The paddles of the bicycle will always move circularly around its chain fixing system because it cannot move in a forward direction without the whole chain system
  3. Both rectilinear and circular: Both rectilinear and circular The wheels of the bicycle will move in rectilinear as well as in circular motion because the wheel as a whole will move forward and its point or particles around the rim will execute circular motion

Question 11. A student measures the length of his classroom four times using a stick

Class 6 Science Chapter 7 Motion And Measurement Of Distances Length Of The Class Room

Based on the above observation, answer the following questions.

1. Which measurement is likely to be wrong?

  1. 1 st time
  2. 2nd time
  3. 3rd time
  4. 4th time

Answer: 3. 3rd time

2. Anil and his friend measured the length of the same classroom using their feet. Will their measurements be the same? Explain your answer.
Answer:

Their measurement will be different because the length of their feet may be different.

3. Which of these is a standard unit of length?

  1. Leg
  2. Stick
  3. Hand
  4. Metre

Answer: 4.  Metre

Question 12. Identify the different types of motion in the following word diagram.

Class 6 Science Chapter 7 Motion And Measurement Of Distances Identify The Different Types Of Motion

Answer:

Different types of motion are represented in word diagrams are

  1. Rectilinear motion
  2. Circular motion
  3. Periodic motion
  4. Lanotator

Question 13. Which type of motion does the rotation of the minute arm involve? Choose Yes or No for the correct response.

Class 6 Science Chapter 7 Motion And Measurement Of Distances Types Of Motion Yes Or No
Answer: 

1.  No

2.  No

3. Yes

4. Yes

Question 14. Which of these could Jenny use to measure her son’s __________________ height? Choose Yes or No for the correct Competency response.

Class 6 Science Chapter 7 Motion And Measurement Of Distances Jenny Use To Measure Her Sons
Answer:

1. Yes

2. No

3. Yes

Question 15. Four children measured the length of a table which was about 2 m. Each of them used different ways to measure it.

Which one of them would get the most accurate length? Give reasons for your answer.

  1. Shyam measured it with a half-metre-long thread.
  2. Gurmeet measured it with a 15 cm scale from her geometry box.
  3. Reena measured it using her handspan.
  4. Salim measured it using a 5 m-long measuring tape.

Answer: 4. Salim measured it using a 5 m-long measuring tape.

  • Salim will measure it most accurately for the following reasons
  • The length 2 m which he wants to measure can be measured using this scale only in a single attempt.
  • This scale is the standard scale and will measure the correct measurements.
  • Other scales given are either non-standard or have a length less than the length we want to measure.

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Short Question And Answers

Question 1. Are all the measurements for the room and table using everybody’s foot and handspan respectively, equal? 
Answer:

The measurement of a room and table using the foot and handspan of different persons will not be equal. This is because the footsteps and handspan of every person are not the same so, their distance can vary.

Question 2.  Boojho is not sure why we say that the distance of the stone from your hand is the same when we whirl it around. Can you help him understand this? Remember that the stone is held with string. 
Answer:

Distance is actually defined as the length between two places. It is clear from the diagram that when we whirl the stone, the length between points A and B , i.e. between hand and stone does not change.

Hence, the distance is the same.

Class 6 Science Chapter 7 Motion And Measurement Of Distances Length Between Two Places

Question 3. Give two examples of each of the modes of transport used on land, water and air.
Ans.

There are mainly three main modes of transport which are given below

  1. Land transports:  Those transports that run on land are called land transports,
    • Example: Bus and truck.
  2. Water transports: Those transports that run on water are called water transports,
    • Example: Boat and ship.
  3. Air transports: Those transports that run in the air are called air transports
    • Example: Aeroplanes and helicopters.

Question 4. Why can a pace or a footstep not be used as a standard unit of length?
Answer:

A pace or a footstep cannot be used as a standard unit of length because the length of a footstep, forearm length and handspan of different persons is different. Since standard units must be similar at all places of the world and in all kinds of conditions. It should not depend upon body parts and natural phenomena. So, footsteps and other such measuring systems cannot be used as a standard unit

Question 5. Why could you not use an elastic measuring tape to measure distance? What would be some of the problems you would meet in telling someone about a distance you measured with an elastic tape?
Answer:

Elastic substances have the property of elasticity, i.e. these can be stretched by applying some force. Therefore, an elastic measuring will not give an accurate measurement. In elastic tape measurement, the measurement of the same object may be different due to its stretching.

Question 6.  Give two examples of periodic motion.
Answer:

Two examples of periodic motions are

  • The motion of the earth around the sun
  • To and fro movement of the bob of a pendulum

Question 7. We need standard units of measurement for a quantity. Explain why?
Answer:

We need standard units of measurement because the units like handspan, foot, and cubit differ from person to person. So, for a uniform measurement, the standard unit of measurement is required.

Question 8. Can the length of the pipe be measured correctly with a ruler? Explain your answer

Class 6 Science Chapter 7 Motion And Measurement Of Distances Ruler

Answer:

The length of the pipe cannot be measured correctly because a ruler can measure the length of straight objects.

Question 9. Correct the following.

  1. The motion of a swing is an example of rectilinear motion.
  2. 1 m = 1000 cm

Answer:

  1. The motion of a swing is an example of periodic motion.
  2. 1 m = 100 cm

Question 10. Mamta Is measuring a piece of wood with a broken meter scale. Her friend Kanchan corrects her by measuring It from any full mark of meter scale.

  1. State the values that Kanchan reflects here.
  2. Give one correct way to measure

Answer:

  1. Kanchan is intelligent, helpful and has good knowledge of the subjects,
  2. One correct way to measure from a broken scale is to start with full marks.

Question 11. There was a quarrel between Ram and Shyam as the measured length of his school table was different from each other. Prlya came and said that calculation of length by Shyam Was more accurate and gave a simple explanation for It.

  1. State the values that Priya reflects here.
  2. Mention the cause for different measurements of Ram and Shyam.

Answer:

  1. Priya is intelligent and has good knowledge upto class 6th
  2. As length measured by Shyam is from measuring tape which is not elastic as of Ram, so they have different measurements.

Question 12. Describe in detail how the thickness of a thin wire can be determined.
Answer:

First of all, take a round pencil and try to wrap the given wire around the pencil making 25 turns forming a coil. Now, measure the length of the wire that turns the formed coil. Divide the total length of the coil by number of turns. This is the thickness of the wire

Question 13. The photograph given In the figure shows a section of a grille made up of straight and curved Iron bars. How would you measure the length of the bars of this section, so that the payment could be made to the contractor?

Class 6 Science Chapter 7 Motion And Measurement Of Distances Grill Made

Answer:

To measure the length of the bars of the grille, the straight part of the iron bar is measured directly with measuring tape and the curved part is firstly measured with thread, then after measuring tape is used to measure the length of the thread.

Question 14. The picture shows the minute arm of a clock rotating

Class 6 Science Chapter 7 Motion And Measurement Of Distances Clock Rotating

Question 15. A car is moving on a road. Suddenly, the driver applies the brakes and stops the car. What can you say about the two states of the car, i.e. when it is moving and when it stops?
Answer:

An object is said to be at rest when it does not change its position with time. If an object changes its position concerning time, it is said to be in motion.

Question 16. Can an object be in motion and rest simultaneously for different observers? Give an example and consequence.
Answer:

Yes, a person driving a car is at rest concerning another person who is sitting in the same car but he is in motion concerning a person standing roadside. The state of motion and rest depends upon the observer or reference point.

Question 17. Briefly explain the type of motion performed by the earth.
Answer:

The earth performs two types of motion. One of the motions is when it moves around the sun, then it is said to possess circular motion and on the other hand, it also rotates about its axis, called rotational motion.

 

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Very Short Question And Answers

Question 1. Are there any early modes of transport that are not in use today? „
Answer: Yes, for example, bullock cart, horse cart, camel cart, etc.

Question 2. Explain how people know how far they have travelled.
Answer: By measuring distance by a particular standard unit of measurement, we can measure how far they have travelled.

Question 3. What would you suggest Paheli and Boojho do, to measure the length of the whole desk? Page 76
Answer: They should use a small length of string instead of a cricket wicket and bails to measure the length of the desk.

Question 4. How can we use a string to measure distance less than the length of the string
Answer: By marking 1/2,1/4 and 1/8 of string length.

Question 5. How would you decide whether an object is in motion or at rest?
Answer: An object is said to be at rest when it does not change its position with time, while an object is said to be in motion when it changes its position with time

Question 6. Mention the two contributions in the 20th century towards transportation.
Answer: The two contributions in the 20th century towards transportation are electric trains and supersonic aeroplanes.

Question 7. Mention some modes of transportation of ancient times.
Answer: In ancient times, there were some modes of transportation like bullock carts, horse carts, camel carts, etc.

Question 8. Name one method of ancient times which is used to measure the length.
Answer: Handspan is one of the methods, which was used to measure the length in ancient times.

Question 9. Mention the name of the universally accepted system of measurement.
Answer: The system of international units is a universally accepted system of measurement.

Question 10. State how many kilometres are there in 1 metre.
Answer: There are \(\) kilometre in 1 metre

Question 11. Give the name of the device used to measure the girth of a tree.
Answer: The device which is used to measure the girth of a tree is a measuring tape.

Question 12. Name the motion exhibited by a freely falling stone.
Answer: The motion exhibited by a freely falling stone is rectilinear.

Question 13. Give the name of the motion possessed by the vehicles on a straight road.
Answer: Rectilinear motion is the motion possessed by vehicles on a straight road.

Question 14. State whether the hour hand of a wall clock is at rest or in motion.
Answer: Due to the changing position of the hand of a wall clock, it always is in motion.

Question 15. State an example of a rotational motion.
Answer: One example of rotational motion is the motion of the earth about its axis.

Question 16. Explain the term non-periodic motion.
Answer: Non-periodic motion is a motion which does not repeat in equal intervals of time.

Question 17. Name the type of motion possessed by the planet around the sun.
Answer: The motion possessed by the planets around the sun is circular motion.

Question 18. Give the name of the motion that a simple pendulum exhibits.
Answer: Periodic motion is exhibited by the simple pendulum.

Question 19. How are the motions of the wheel of a moving bicycle and a mark on the blade of a moving electric fan different? Explain.
Answer: The motions of the wheel of a moving bicycle and a mark on

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Fill In The Blanks

Question 1. One metre is  ___________cm.
Answer:  100

Question 2. Five kilometres is ______ m.
Answer:  5000 [v 1 km = 1000 m]

Question 3. The motion of a child on a swing is ________
Answer:  Periodic motion

Question 4. Motion of the needle of a sewing machine is ___________
Answer:  Periodic motion

Question 5. The motion of a wheel of a bicycle is ______
Answer:  Circular motion

Question 6. Different modes of ___________ are used to go from one place to another _____
Answer:  Transport

Question 7. The length of a curved line can be measured by using ___________
Answer: Thread or measuring tape

Question 8. The metric system for measurement was created by the ___________
Answer:  French

Question 9. The SI unit of length is ___________
Answer:  Metre

Question 10. 2000 cm is equal to ___________ metre
Answer:  20

Question 11. Motion is the change In ___________of in object.
Answer:  Position

Question 12. The motion of an object or a part of it around a fixed point is Known as ___________ motion.
Answer: Circular

Question 13. A body repeating its motion after a certain Interval of time is in ___________ motion
Answer: Periodic

Question 14. In rectilinear motion, the object moves ___________ a ___________ line
Answer: In, Straight

Question 15. A plucked string of a star executes ___________ motion.
Answer:  Oscillatory

Question 16. The motion that repeats itself after a regular interval of time is _____________________
Answer: Periodic motion

Question 17.  A stone falling from a height exhibits _______________________motion.
Answer: Rectilinear

Question 18. The length between the tip of the middle finger and the chin of an outstretched arm is ______________
Answer:  Yard

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances True Or False

Question 1. An elastic tape cannot give a true measurement 
Answer: True

Question 2. A cloth merchant uses a meter rod to measure the length of the cloth. 
Answer: True

Question 3. From a broken meter scale, measurement can be done from a zero mark.
Answer: False

Question 4. One metre is equal to 1000 cm.
Answer: False

Question 5. The SI unit of distance is cm.
Answer: False

Question 6. The motion of the earth about its axis is rotatory.
Answer: True

Question 7. A flying bird in the sky is at rest.
Answer: False

Question 8. The motion of the wheel of a car is rectilinear as well as circular motion.
Answer: True

Question 9. The object which does not change its position time is said to be at rest.
Answer: True

Question  10. A centimetre is a smaller unit than a millimetre.
Answer: False

Question 11. The measuring tape is used to measure the girth of a tree.
Answer: True

Question 12. A spinning top shows circular motion.
Answer: True

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Assertion-Reason Question And Answers

The following questions consist of two statements Assertion (A) and Reason (R). Answer these questions by selecting the appropriate option given below.

  1. Both A and R are true and it is the correct explanation of A.
  2. Both A and R are true but R is not the correct explanation of A
  3. A is true but R is false
  4. A is false but R is true

Question 1.

Assertion (A):  The SI unit of length is metres.

Reason(R): A yard gives the accurate measurement of length.

Answer: 3. A is true but R is false

A yard does not give the correct length because a yard is the length from the chin to the thumb of an outstretched arm. It may vary from person to person.

Question  2.

Assertion (A): While travelling? bus and co-travellers appear to be stationary.

Reason (R):  The position of co-passengers is not changing concerning each other.

Answer: 1. Both A and R are true and it is the correct explanation of A.

Co-travellers appear to be stationary because all are moving at the same speed, so the positions of co-passengers are not changing concerning each other.

Question 3.

Assertion (A): The motion of the earth around the sun is periodic.

Reason (R): The earth repeats its motion after a fixed interval of time.

Answer: 1. Both A and R are true and ft is the correct explanation of A.

The earth repeats its motion every 1 year, hence its motion is periodic.

Question 4.

Assertion (A):  A rolling ball on the ground shows only rectilinear motion.

Reason (R):  A rolling ball moves from one place to another

Answer: 4. A is false but R is true

An assertion is false because the rolling ball shows both rectilinear and rotational motion.

NCERT Class 6 Science Chapter 7 Motion And Measurement Of Distances Match The Columns

Question 1. Match Column A with Column B

Class 6 Science Chapter 7 Motion And Measurement Of Distances Match The Columns

Answer:  1- B, 2- A, 3- C

Distraction Osteogenesis Question And Answers

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Distraction Osteogenesis Definition

Distraction osteogenesis: It is a technique by which lengthening of a bone by new bone formation occurs in between the 2 osteotomies distracted fragments

Distraction Osteogenesis Short Essays

Question 1. Distraction osteogenesis.
Answer:

Distraction Osteogenesis of Definition:
Distraction Osteogenesis Short Essay Question And Answers

It is a technique by which lengthening of a bone by new bone formation occurs in between the 2 osteotomised distracted fragments

Distraction Osteogenesis of Advantages:

  • Safer
  • Decreased morbidity
  • Decreased operative time
  • Conservative
  • Can be done in younger patients
  • No bone grafting needed
  • Growth of bone & soft tissue

Distraction Osteogenesis Phases

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

Distraction Osteogenesis of Indications:

  1.  Mandibular:
    • Microsomia
    • Syndromes
    • TMJ conditions
    • Trauma
    • Deficiencies
  2. Maxillary:
    • Cleft lip/ palate
    • Deficiency
    • Palatal expansion
  3. Craniofacial:
    • Syndromic condition

Distraction Osteogenesis of Steps:

  • Surgical fracture
  • Controlled segmental movement
  • The bone formation between segments
  • Soft tissue remodeling

Distraction Osteogenesis Phases

Distraction Osteogenesis of Principles:

  1.  Bone cut:
    • Done along with preserving the blood supply
  2. Latency:
    • 5–7 days in older patients
    • 1–2 days in younger patients
  3.  Rate:
    • It refers to the amount of separation Usually needed 1 mm per day
    • Younger patients: 1.5-2 mm per day
    • In necrosed patients: 0.5-1 mm per day
  4. Rhythm:
    • Refers to frequency of application of force
    • 2 times a day
  5. Consolidation phase:
    • 4–6 weeks
  6. Retention phase:
    • Refers to the removal of appliances & stabilization of the jaw.

Distraction Osteogenesis The Regeneration Pattern

Orthognathic Surgery And Osteotomy Procedures Question And Answers

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Orthognathic Surgery And Osteotomy Procedures Important Notes

1. Indications of sagittal split osteotomy:

  • Mandibular prognathism
  • Mandibular retrognathia
  • Bimaxillary protrusion
  • Skeletal open bite
  • Mandibular excess

2. Classification of osteotomy procedures:

  1. Mandibular body osteotomies
    • Mandibular body osteotomies
      • Anterior body
      • posterior body
      • Midsymphysis
    • Segmental Subapical
      • Anterior
      •  Posterior Total
    • Genioplasties
      • Augmentation
      • Reduction
      • Straightening
      • Lengthening
  2. Mandibular ramus osteotomies
    •  Sub condylar
    •  Bisagittal split
  3.  Maxillary osteotomy procedures
    • Segmental
      • Single Tooth
      • Interdental
      • Anterior
      • Posterior
    •  Total
      • Superior repositioning
      • Inferior repositioning
      • Advancement of maxilla
      • Leveling of maxilla

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

3. Types of genitoplasty:

  • Augmentation genioplasty
  • Reduction genioplasty
  • Straightening genioplasty
  • Lengthening genioplasty

Orthognathic Surgery And Osteotomy Procedures Types Of Genioplasty

4. Treatment for mandibular prognathism:

  • Sagittal split osteotomy with mandibular setback Oblique sub condylar osteotomy

5. Bilateral sagittal split osteotomy:

  • First described by Trauner and Obwegesser
  • Modified by Dalpont, Hunsuck, and Epker It is the most popular and versatile procedure
  • Performed on mandibular ramus and body
  • The osteotomy splits the ramus and the posterior body of the mandible sagitally
  • This allows either setbacks or advancement

6. Various malocclusion and their treatment options;

Orthognathic Surgery And Osteotomy Procedures Various Malocclusion And Treatment Options

Orthognathic Surgery And Osteotomy Procedures Long Essays

Orthognathic Surgery Question And Answers

 

Question 1. Pre-operative planning in orthognathic surgery.
Answer:

Assessment Of Patient:

  • Includes:
    • Patient’s chief complaint
    • Patient’s expectations
    • Medical status of the patient
  • Patient’s Examination:
    • Hard & soft tissues examination
    • TMJ evaluation
  • Measurement of Facial Proportions:
    • Dividing facial contour in 3 horizontal planes & comparing them
    • Dividing facial contour in 3 vertical planes & comparinging them
    • Facial profile examination
  • Radiographic Examination:
    • Conventional radiography: For assessing any pathology
    • Cepholometric analysis
    • Hard & soft tissue landmarks are marked & jaw & face
    • contour is analysed
    • Special radiography done
    • Facial photography: For maintaining records
    • For computer-aided analysis
    • For treatment planning
    • For comparing pre- & post-operative appearance
  • Model Surgery:
    • Involves the construction of occlusal models
    • Predict any occlusal problems
    • Modify orthognathic movements
  • Treatment Planning:
    • All data is collected
    • Analysis is done
    • Review all orthodontic & surgical options
    • Decision made on whether surgical or orthodontic treatment is required

Phases of Treatment:

  1.  Pre orthodontic preparatory phase
    • Treatment of periodontics & restorative problems
  2. Pre-surgical orthodontics
    • Orthodontically aligning of teeth
  3. Surgical phase
    • Model surgery done
    • Fabrication of splint
    • Osteosynthesis done
  4. Post-surgical phase
    • 4–8 weeks after surgery
    • Closing of spaces present
    • Removal of orthodontic brackets
    • Applying retainers
  5. Prosthodontics phase
    1.  Placement of implants
    2. Periodontal management
    3. Esthetic restoration

Orthognathic Surgery And Osteotomy Procedures Short Essays

Question 1. Bilateral sagittal split osteotomy.
Answer:

Bilateral sagittal split osteotomy

Described by Obwegeser & Trauner

Procedure of Bilateral sagittal split:

  • Bite block inserted on opposite side
  • Incision made on lateral ascept of anterior border of the ramus
  • Extend the incision into the vestibular depth
  • Soft tissue dissection done
  • Soft tissues are reflected
  • Medial bone cut is done through lingual cortex
  • Cut extended upto second molar region bite block is removed
  • Separate the segments with the help of osteotome
  • Accordingly, advancement or setback is done
  • Fix the fragment

Orthognathic Surgery And Osteotomy Procedures Diagram For Intraoral Sagittal Split Osteotomy

Orthognathic Surgery And Osteotomy Procedures Diagram For Intraoral Sagittal Split Osteotomy.

Question 2. Anterior maxillary osteotomy.
Answer:

Anterior Segmental Osteotomies:

  • Indications:
    • Pre-maxillary protusion
    • Deep bite
    • Anterior open bite

1. Wassmund Procedure:

  • Blood supply is from palatal mucoperiosteum Vertical incision given in the premolar region
  • A small vertical incision given in the midline to expose the anterior nasal spine
  • Premolars are extracted
  • Buccal bone cuts are made
  • The palatal cortical plate is cut vertically
  • · Detach the nasal septum
  • Mobilize the segment
  • Reposition it to the desired position
  • Fix it
  • Closure of wound

Orthognathic Surgery And Osteotomy Procedures Wassmund Technique

2. Wunderer’s Procedure:

  •  Blood supply is from buccal mucoperiosteum
  • Horizontal incision is given across the palate
  • Vertical incisions made in buccolabial sulcus
  • A small vertical incision given in the midline to expose the anterior nasal spine
  • Extract the premolars
  • Buccal bone cuts given
  • Detach nasal septum
  • Mobilize palatal bone cut
  • Mobilize anterior segment
  • Fix & sutured it

Orthognathic Surgery And Osteotomy Procedures Wunderer Technique

Question 3. Mandibular hypertrophy.
Answer:

Features of Mandibular Hypertrophy:

  1. Extraoral features:
    • Concave profile
    • Anterior facial divergent
    • Prominent chin
  2. Intraoral features:
    • Class 2 malocclusion
    • Lingually tilted lower incisors
    • Anterior cross bite
    • Narrow upper arch
    • Wide lower arch
    • Posterior crossbite
    • Crowded upper teeth
    • Spacing present in lower teeth

Treatment of Mandibular Hypertrophy:

  • Chin cup therapy to restrict maxillary growth
  • In nongrowers
  • Surgical mandibular setback which is followed after split osteotomy

Question 4. Genioplasty.
Answer:

Genioplasty

Used as an adjunctive

Types of Genioplasty:

  1. Augmentation genioplasty:
    • Deglove inferior border of the symphysis
    • Periosteal releasing incision given
    • Horizontal osteotomy cut given at the apices of canine
    • Segment is mobilized
    • Removal of bony interferences
    • Check for the facial contour
    • Fix the superior body
  2. Reduction genioplasty:
    • Horizontal osteotomy cuts are given
    • Setback the fragment
    • Excise the bony interference
    • Fix the fragment
  3.  Straightening genioplasty:
    • Horizontal osteotomy cut are given
    • Shift segment laterally
  4.  Lengthening genioplasty:
    • Horizontal osteotomy cut are given
    • Segment is shifted inferiorly
    • Bone graft is sandwiched between the fragments.

Orthognathic Surgery And Osteotomy Procedures Sliding And Reduction Genioplasty

Orthognathic Surgery And Osteotomy Procedures Augmentation Genioplasty

Orthognathic Surgery And Osteotomy Procedures Double Sliding augmentation Genioplasty

Question 5. Cephalometry
Answer:

  1. Introduced by Broadbent in USA & Hofrath in Germany in 1931
  2. Describes analysis & measurements made on the cephalometric analysis

Types of Cephalometry:

  1. Lateral cephalogram
  2. Frontal cephalogram

Uses of Cephalometry:

  • For diagnosis
  • To study dental & soft tissue structures
  • For the classification of skeletal & dental abnormalities
  • Assess facial type
  • For treatment planning
  • For presuming results
  • For predicting growth-related changes
  • For research work

Question 6. Treatment for mandibular prognathism.
Answer:

Treatment for mandibular prognathism

  • Sagittal split osteotomy with mandibular setback
  • Oblique sub condylar osteotomy
    • Described by Obwegeser & Trauner

Procedure of Treatment for mandibular prognathism:

  • Bite block inserted on the opposite side
  • Incision made on the lateral aspect of the anterior border of the ramus
  • Extend the incision into the vestibular depth
  • Soft tissue dissection done
  • Soft tissue reflected
  • Medial bone cut done in second molar region
  • The bite block is removed
  • Separate the segments with the help of osteotome
  • Setback is done
  • Fix the fragment

Orthognathic Surgery And Osteotomy Procedures Short Question And Answers

Question 1. Shift cone technique.
Answer:

Shift cone technique

It is an object localization technique

Technique of Shift cone:

  • A standard radiograph is taken
  • The tube is shifted either mesially or distally
  • Second radiography is taken
  • If an object appears on the same side, then it is located lingually
  • If the object appears on the opposite side in the radiograph, then it is located buccally
  • Also called same lingual opposite buccal [Slob Technique]

Question 2. Indications of sagittal split osteotomy.
Answer:

Indications of sagittal split osteotomy

  • Mandibular prognathism
  • Mandibular retrognathia
  • Bimaxillary protrusion
  • Skeletal open bite
  • Mandibular excess

Question 3. Classification of Osteotomy procedures.
Or
Mandibular orthognathic producers.
Answer:

  1. Mandibular body osteotomies:
    • Mandibular body osteotomies:
      • Anterior body
      • posterior body
      • Midsymphysis
    • Segmental Subapical:
      • Anterior
      • Posterior
      • Total
    • Genioplasties:
      • Augmentation
      • Reduction
      • Straightening
      • Lengthening
  2.  Mandibular ramus osteotomies:
    1. Sub condylar
    2. Bisagittal split
  3. Maxillary osteotomy procedures:
    • Segmental:

      • Single Tooth
      • Interdental
      • Anterior
      • Posterior
    • Total:
      • Anterior
      • Posterior
      • Superior repositioning
      • Inferior repositioning
      • Advancement of maxilla
      • Levelling of maxilla

Question 4. Define orthographic surgery.
Answer:

Orthographic surgery

  1. Orthognathic surgery is the art and science of diagnosis treatment planning & execution of treatment by combining orthodontics & oral & maxillofacial surgery to correct musculoskeletal endosseous & soft tissue deformities of the jaws & associated structures.
  2. In severe skeletal deformities, orthodontic along may compromise stability & esthetics & surgery alone may compromise function & stability.

Ortho gnathic Surgery And Osteotomy Procedures Viva Voce

  1. Genitoplasty is done to correct the deformities of the chin without altering the denture-bearing part
  2. Anterior maxillary osteotomy is combined with an anterior subapical mandibular osteotomy to correct bimaxillary protrusion
  3. In reduction genioplasty, the symphysis part of the mandible is reduced so that chin will attain a straight profile
  4. Lefort I osteotomy are commonly performed procedure for the treatment of maxillary retrognathia
  5. Apertognathia is a condition in which there is open bite deformity
  6. During genitoplasty there are chances of injuring mental nerve

 

Maxillofacial Trauma Question And Answers

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Maxillofacial Trauma Important Notes

1. Classification of fracture

  • Classification of Fractures of Maxilla: 
    1. Lefort classification
      • Lefort 1
      • Lefort 2
      • Lefort 3
    2. Erich’s classification Horizontal fracture
      • Pyramidal fracture
      • Transverse fracture
    3. Depending to the zygomatic bone
      • Sub zygomatic
      • Supra zygomatic
    4. Depending on level
      • Low level
      • Mid-level
      • High level
  • Classification of Mandibular Fractures:
    • General classification
      1. Simple/closed
        • Doesn’t communicate with the exterior
      2. Compound
        • It communicates with exterior
      3. Comminuted
        • Bone is crushed into pieces
      4. Complex
        • Involvement of vital structures
      5. Impacted
        • One fragment driven into other
      6. Greenstick
        • Fracture of one fragment & bending of other
      7. Pathological
        • Superimposition of disease
    • Completeness
      • Complete fracture
      • Incomplete fracture
    • According to the favourability & direction
      • Horizontal favourable fracture
      • Horizontal unfavourable fracture
      • Vertical favourable fracture
      • Vertical unfavourable fracture

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

    • Kazanjian classification:
      • Class 1: When teeth present on both sides of the fracture line
      • Class 2: When teeth are present only on one side of the fracture line
      • Class 3: When either side of the fracture line is edentulous
    • Anatomical classification:
      • Symphysis fracture
      • Canine region fracture
      • Body fracture
      • Fracture of angle
      • Fracture of ramus
      • Coronoid fracture
      • Condylar fracture
      • Fracture of dentoalveolar region

Anatomical classification

2. Favourable and unfavorable fractures:

  1. Horizontally favorable fracture: When viewed from side, the fracture line runs from the lower border of the mandible extending upward and backward to meet the upper border
  2. Horizontally unfavorable fracture: The fracture line extends from the lower border in an upward and forward direction to meet the upper border
  3. Vertically favorable fracture: When viewed from above the fracture line that runs from buccal plate obliquely backward towards the lingual plate, it will resist medial displacement of the posterior segment
  4. Vertically unfavorable fracture: If the vertical direction of the fracture line favors the unopposed action of the medial pterygoid muscle, the posterior fragment will be pulled lingually

3. Management of mandibular fractures

  •  Wiring:
    • Essig’s wiring
    • Gilmer’s wiring
    • Risdon wiring
    • Eyelet wiring
    • Multiloop wiring
  • Arch bar fixation
  • Bone plating

4. Important features of different types of fractures:

Maxillofacial Trauma Importance features Of Different Types Of Fractures

5. Methods of immobilization of mandibular fractures:

  • Osteosynthesis without IMF
  • Intermaxillary fixation
  • IMF with osteosynthesis

6. Principles of fracture management:

  • Reduction
  • Fixation
  • Immobilization

7. Line of fracture:

  1. Lefort 1:  Fracture line extends from the nasal septum to the lateral pyriform rims, travels horizontally above the teeth apices runs below the zygomatic buttress and crosses the lower third of the pterygoid laminae
  2. Lefort 2: The fracture line runs from the middle area of the nasal bone down either side crossing the frontal process of the maxilla into the medial wall of each orbit  Within each orbit the line crosses the lacrimal bone behind the lacrimal sac
  3. Lefort 3: The fracture line extends from the frontonasal suture transversely backward parallel with the base of the skull and involves full depth of the ethmoid bone including the cribriform plate

8. Classification of condylar fractures

  • General classification:
    • Simple fracture
    • Compound fracture
    • Comminuted fracture
  • Lindhal classification:
    1. Fracture level
      • Condylar head fracture
      • Condylar neck fracture
      • Subcondylar fracture
    2. Relationship of the condyle to ramus:
      • Undisplaced
      • Deviated
      • Displaced with medial overlap
      • Displaced with lateral overlap Anteroposterior overlap
    3. Relationship of condylar head to fossa:
      • No displacement
      • Displacement
      • Injury to meniscus
  • Maclennan classification:
    • No displacement
    • Deviated
    • Displacement
    • Dislocation

9. Complications of fractures:

  1. Early complications:
    • Local:
      • Haemorrhage- Internal or external
      • Damage to vital structures
      • Damage to surrounding tissues, nerves or skin
      • Haemarthrosis
    • Systemic complications:
      • Fat embolism
      • Shock
      • Thromboembolism
      • Pneumonia
  2. Late complications
    • Local Complications:
      • Delayed union
      • Non-union
      • Malunion
      • Myositis ossificans
    • Systemic complications:
      • Gangrene, tetanus, septicaemia
      • Osteoarthritis

Maxillofacial Trauma Long Essays

Question 1. Classify fractures of maxilla & mandible. Discuss the management of mandibular fractures. Management And types of Dental Wiring
Answer:

Classification Of Fractures Of Maxilla:

  1. Lefort classification:
    • Lefort I
    • Lefort II
    • Lefort III
  2.  Erich’s classification:
    • Horizontal fracture
    • Pyramidal fracture
    • Transverse fracture
  3.  Depending to the zygomatic bone:
    • Sub zygomatic
    • Supra zygomatic
  4.  Depending on level:
    • Low level
    • Mid level
    • High level

Classification of Mandibular Fractures:

1. General classification:

  • Simple/closed: Doesn’t communicate with exterior
  • Compound: It communicate with exterior
  • Comminuted: Bone is crushed into pieces
  • Complex: Involvement of vital structure
  • Impacted: One fragment driven into other
  • Greenstick: Fracture of omne fragment and bending o other
  • Pathological: Superimposition of disease

2. Completeness:

  • Complete fracture
  • Incomplete fracture

3. According to the favourability & direction:

  • Horizontal favorable fracture
  • Horizontal unfavorable fracture
  • Vertical favorable fracture
  • Vertical unfavorable fracture

4. Kazanjian classification:

  • Class 1: When teeth present on both sides of the fracture line
  • Class 2: When teeth are present only on one side of fracture line
  • Class 3: When either side of the fracture line is edentulous

5. Anatomical classification

  • Symphysis fracture
  • Canine region fracture
  • Body fracture
  • Fracture of angle
  • Fracture of ramus
  • Coronoid fracture
  • Condylar fracture
  • Fracture of dentoalveolar region

Maxillofacial Trauma Simple Fracture And Grrenstick

Maxillofacial Trauma Compound Comminuted Fracture And Compound Fracture

Maxillofacial Trauma Simple Comminuted Fracture

Maxillofacial Trauma Dingman And Natvigs

Clinical Features Of Fractures Of Maxilla:

  • Change in the contour of the face
  • Lacerations
  • Ecchymosis of the floor of mouth Occlusal disturbances
  • Step deformity of the mandible
  • Pain & tenderness
  • Trismus
  • Deviated mouth opening
  • Anaesthesia & paraesthesia of the lower lip & chin

Management and types of Dental Wiring:

1. Essig’s wiring:

  • Used to stabilize dentoalveolar structures
  • Steps:
    • Move the luxated teeth back to the position
    • Adapt wire to the teeth
    • Pass the wirws one end buccly and other lingually
    • Join both the ends
    • Pass small wires Interdentally and fix it
    • Twist it cut it and adjust in

Maxillofacial Trauma Essigs Wiring

2. Gilmers wiring:

Maxillofacial Trauma Simple Gilmers Wining

  • Pre stretched wire is passed around the individual tooth
  • Both ends are brought together & twisted Repeat for each tooth
  • Repeat for both the arches
  • Final twisting mandibular & maxillary wires
  • Twist cut it & adapt interdentally

3. Risdon’s wiring:

  • Pass the wire around both the 2nd molar
  • Both the ends are twisted together
  • Repeat for each tooth
  • Both the base wires are brought to the midline
  • Twisted together
  • Cut it
  • Adapt it to the neck of the teeth

Maxillofacial Trauma Steps In Forming A Risdons Wiring

4. Eyelet wiring:

  • Prepare loops in the center of wire
  • Two tails of the wire are passed interdentally
  • One end is passed around distal tooth from lin gually to buccally
  • Other end is passed around mesial tooth lingually to buccally
  • Twist both the ends
  • Cut it short

Maxillofacial Trauma Ivy Eyelats Wiring Eyelats Formation

Maxillofacial Trauma Ivy Eyelats Wiring The Arrangement Of Tie wires In V Parttern

Maxillofacial Trauma Intermaxillary Ligation Using Eyelats Wiring In A Straight Pattern

5. Multiloop wiring:

  • Adapt solder wire around the buccal surface of the tooth
  • Adapt wire buccally from last molar to midline
  • Pass the other end distal to the 2nd molar over lingual side
  • Pass interdentally bring it to the buccal side by passing under the wire
  • Now pass it from buccal to lingual
  • Round it around the tooth
  • Repeat the same procedure

Maxillofacial Trauma Col. Stouts Multi Loop Wiring

6. Arch Bar Fixation:

It is a method of indirect fixation used in the management of mandibular fractures.

Structure of Arch Bar Fixation:

  • Stainless steel strip consisting of hooks
  • In upper jaw hooks are located in upward direction
  • In lower jaw it is located in downward direction
  • It is adapted to the buccal surface
  • It is fixed to each tooth with the help of stainless steel wires

Maxillofacial Trauma Arch Bar Fixation

Advantages of Arch Bar Fixation:

  1. Less traumatic
  2. Stable appliance

Question 2.  Describe clinical features & management of Lefort 1.
Or
Classify fractures of the middle third of the facial skeleton. How would you manage Leforte Fractures?
Or
Lefort 1 fracture And Geurin fracture
Answer:

Lefort 1:

  • Clinical Features of Lefort 1:
    • Oedema of lower part of face
    • Ecchymosis in buccal vestibule
    • Bilateral epitaxis
    • Mobility of upper teeth
    • Disturbed occlusion
    • Pain
    • Upward displacement of fragment telescopic fracture
    • ‘Cracked cup’ sound on percussion of upper teeth
  • Guerin sign’ecchymosis in the greater palatine region

Maxillofacial Trauma Lefort 1 Fracture Lines

Management of Lefort 1:

  • Principles:
    1. Reduction
    2. Fixation
    3. Immobilization

Principles are of Lefort 1:

1. Reduction:

  • Reduction of impacted fragment with the help of disimpaction forceps ( Rowe’s & William’s forceps)
  • Placement of Rowe’s forcep:
  • The straight blade is placed into the nostrils
  • A curved blade is placed over the palate
  • Placement of William’s forceps: placed over the buccal accept
  • Displaces maxilla in mesiodistal direction

Maxillofacial Trauma Reduction Of Maxillary Fractures

2. Fixation:

  • Zygomatic suspension fixation is done
  • Holes are drilled over the zygomatic arch
  • Pass the wire through it
  • Bring it up to the arches
  • Twisted over are arch bars

3. Inter Maxillary Fixation:

Maxillofacial Trauma Introal Traction

Maxillofacial Trauma Introal Fixation By Ligation With Wires IML Or IMF

Question 3. Classify zygomatic fractures. Describe about its clinical features & its management.
Or
How to the management of zygomatic fracture and Gillies Temporal Approach.
Answer:

Classification of zygomatic fractures:

  1. Based on the extent of involvement:
    • Fractures involving orbit
    • Fractures not involving the orbit
  2. Zingg classification:
    • Type 1:
      • Isolated to one component
      • Zygomatic arch
      • lateral orbital wall
      • Inferior orbital rim
    • Type 2:
      • Involving all four buttresses
    • Type 3:
      • Complex fractures
  3. Based on direction:
    • Displacement around a horizontal axis
    • Displacement around vertical axis

Clinical Features of zygomatic fractures:

  • Flattening of cheek
  • Unilateral epistaxis
  • Tearing of sinus mucosa causes blood to collect into the sinus cavity
  • As the maxillary sinus drains into the middle meatus, unilateral epistaxis occurs
  • Circumorbital ecchymosis
  • Subconjunctival hemorrhage
  • Due to the ability of oxygen to diffuse through conjunctiva to the collected blood under the conjunctiva
  • Limitation of ocular movements
  • Enophthalmus
  • Due to herniation of orbital contents through the fractured walls
  • Blurring of vision
  • Anesthesia of cheek
  • Edema of cheek
  • Step deformity
  • Limitation of mandibular movements Trismus
  • Due to spasm of temporalis by impingement of zygomatic arch fragments on muscle

Management of zygomatic fractures:

  • Stable fractures: open reduction
  • Unstable fractures open reduction & trans osseous wiring

Operative Technique:

  • Gillies Temporal Approach:
    • Plugged external auditory meatus with cotton
    • Incision given over zygomatic arch as well as temporal area
    • Expose temporal fascia
    • Insert Bristow’s periosteal elevator above the temporal muscle
    • Manipulate it upward, forward & outward
    • Reduction is done
    • Closure of wound

Maxillofacial Trauma Gillies temporal Approach For Reduction Of Zygomatic Bone

Maxillofacial Trauma Gillies Temporal Approach For Reduction Of Zygomatic Bone Arch Fracture

Question 4. Classify condylar fractures. Describe its clinical features, & its management.
Or
Clinical features & management of condylar
Answer:

Classification of condylar fracture:

1. General classification:

  • Simple fracture
  • Compound fracture
  • Comminuted fracture

2. Lindhal classification:

  • Fracture level:
    • Condylar head fracture
    • Condylar neck fracture
    • Subcondylar fracture
  • Relationship of the condyle to ramus:
    • Undisplaced
    • Deviated
    • Displaced with medial overlap
    • Displaced with lateral overlap
    • Anteroposterior overlap
  • Relationship of condylar head to fossa:
    • No displacement
    • Displacement
  • Injury to meniscus:

Lindhal’s classification of condylar fracture:

Maxillofacial Trauma Lindhals Classification

  • CH – Condylar head intracapsular fracture
  • CN-  Condylar neck fracture,
  • SC – Subcdylar fracture

3. Maclennan classification:

  • No displacement
  • Deviated
  • Displacement
  • Dislocation

Maxillofacial Trauma Maclennans Of Condylar Fractures

  1. No displacement
  2. Displacement
  3. Deviation
  4. Dislocation
  5. Comminution (Multiple fragmentation)

Relation ship of the condylar fragment:

Maxillofacial Trauma Relationship Of The Condylar Fragment

  • 1 – To the Mandibular ramus stump
  • 2-  To the Glenoid fossa

Clinical Features of condylar fracture:

  • Abrasion over the fractured area
  • Difficulty in mastication
  • Laceration over chin
  • Facial nerve injury
  • Limitation in mouth opening
  • Deviation of chin
  • Bleeding of external auditory meatus
  • Pain
  • Lack of condylar movement
  • CSF leak

Intraorally of condylar fracture:

    • Premature contact of molars
    • Posterior open bite
    • Crossbite
    • In bilateral cases: Anterior open bite with posterior gagging” Guardman’s Fracture”

Management of condylar fracture:

  1.  Non-Surgical treatment:
    • Restrict the movements
    • Restrict the diet to semisolid
    • Application of class II elastic traction
    • Correction of malocclusion
    • IMF for 2-3 weeks
  2. Surgical treatment:
    1. Absolute indications:
      • Dislocation in middle cranial fossa
      • Anterior dislocation
      • Bilateral condylar fracture
    2. Relative indications:
      • subcondylar fracture with anterior openbite
      • Anterior & medial displacement of the fragment
      • Malunited fracture
      • Loss of posterior teeth
      • Interference with the functions

Question 5. Write diagnosing & management of fracture of angle of the mandible in 40 years old edentulous patient.
Answer:

Diagnosis of fracture :

  • Making of impression of upper & lower arches
  • Fabrication of cast models
  • Study of occlusion through it
  • Model surgery is carried out through it

Management of fracture :

  • Use of denture for fixation & immobilization of fragment
  • The denture can be used as a splint
  • Splinting of the denture by circum mandibular wiring
  • If dentures are not present
  • Impression is taken of upper & lower arches Processing of acrylic baseplates
  • Used as denture called
  • Gunning Splint
  • Processing of archbars into dentures
  • Wiring of denture
  • Prosthetic incisors are removed to create a hole for feeding purposes

Maxillofacial Trauma Gunning Splint

Question 6. Write clinical features & management of Lefort 3
Answer:

Clinical Features of Lefort 3:

  • Balloning of face
  • Panda facies
  • Racoon eyes
  • bilateral subconjunctival hemorrhage
  • lengthening of face
  • Separation of sutures
  • ‘Dish face’ deformity
  • Enophthalmus
  • Diplopia
  • Deviation of nasal bridge
  • Epitaxis
  • CSF rhinorrhoea

Maxillofacial Trauma Lefort 3 Fracture Lines

Management of lefort 3:

Maxillofacial Trauma Lefort 3 Management

Question 7. Describe the management of unfavorable fractures.
Answer:

Management of unfavorable fractures:

Maxillofacial Trauma Horizontally Favourable Line Of Fracture Angle Of the Mandible

Maxillofacial Trauma Horizontally Unfavourable Line og Fracture Angle Of The Mandible

Maxillofacial Trauma Vertically Favourable Line Of Fracture Right angle Of The Mandible

Maxillofacial Trauma Vertically Unfavorable Line of Fracture Line Of Fracture Right Angle Of The Mandible

Question 8. Write in short principles of fracture management. Add a note on different modalities for fracture mandible involving teeth in the line of fracture.
Or
Fracture of the body of the mandible in children.
Answer:

Principles Of Fracture Management:

  1.  Reduction:
    • Restoration of fractured fragments to their original position
    • Brought by
      • Closed reduction
      • Open reduction
  2.  Fixation:
    • Fractured fragments are fixed
    • This prevent displacement of the fragments
      • Consists of:
        • Direct fixation
        • Indirect fixation
  3. Immobilization:
    • Fixation device is retained in position till bony union is obtained
    • It depends on type of fracture & bone involve

Management Of Fracture Of Mandible Involv- Ing Teeth In The Line Of Fracture:

  1. Teeth can be extracted or retained
  2.  Indications for them

Maxillofacial Trauma Indications

Maxillofacial Trauma Short Essays

Question 1. Diplopia.
Answer:

Diplopia

  • It is a blurred, double vision experienced by the patient
  • It can be temporary or permanent

Types of Diplopia:

  1. Monocular Diplopia:
  2. Double vision through one eye
    • Indicates detached lens or traumatic injury
  3.  Binocular diplopia:
    • Blurred through both the eyes

Causes of Diplopia:

  1. Physical interference:
    • Fibrous adhesions Haematoma
    • Herniation of periorbital fat
  2. Functional interference:
    • Disturbance to the inferior rectus & inferior oblique muscle
  3. Neurological causes:
    • Paralysis of nerve
    • Supranuclear impairment
    • Intraorbital damage
    • Infranuclear injuries

Diagnosis of Diplopia:

1. Testing motions of the eye:

  • Hold a pencil at an arm distance from the patient
  • Ask the patient in all the 9 direction
  • Observe obstruction in any direction if present

Maxillofacial Trauma Testing The Motions of the Eyes In All Nine Positions Of gazes

2. Forced duction test:

  • Grasp the tendon of inferior rectus through forceps
  • Ask the patient to look in all the direction
  • Observe any obstruction

Maxillofacial Trauma Vertically Forced Duction Test To Check The Entire Range Of Occular Motion

3. Hess test:

  • Patient’s motions of the eye are recorded over a Hess chart

Question 2. Lefort II fracture/ Pyramidal fracture.
Answer:

Lefort II fracture/ Pyramidal fracture:

Maxillofacial Trauma Lefort 2 Fracture Lines

Clinical Feature sof Lefort II fracture:

  • Gross edema of middle third of the face
  • Ballooning of face
  • Black eye
  • Bilateral subconjunctival hemorrhage
  • Depressed nasal bridge
  • Anterior open bite in case of impacted fracture
  • If the fragment is displaced downward, it causes lengthening of face
  • Bilateral epistaxis
  • Loss of occlusion
  • Difficulty in mastication & speech
  • Airway obstruction
  • CSF leak
  • Paraesthesia of cheek
  • Step deformity

Question 3. Splints.
Answer:

Types of Splints:

  1. Custom made:
    • Fabricated for the individual patient
      • Indications:
        • Failure of wiring Edentulous patient
        • Pregnant patients Growing children
  2. Acrylic:
    1. Types: Lateral compression splint
    2. Steps:
      • Make impression
      • Fabricate cast
      • Mark & cut the fracture line
      • Check for occlusion
      • Adapt wire to it
      • Fabricate the acrylic splint with the help of self cure acrylic
  3. Gunning splints:
    • Modification of dentures in case of edentulous patient
      • Fixation:
        • In mandibular circumferential wiringalges to athl
        • In maxilla pre alveolar wiring

Question 4. Miniplate osteosynthesis.
Answer:

Miniplate osteosynthesis

Developed by Michelet in 1973

  1. AIM:
    • To attain fracture adaptation
    • Application of the plate to the traction side of the bone
  2. Principle:
    • Fixation by stability
  3. Factors:
    • Location of dense cortical bone
    • Displacing forces acting on the mandible

Question 5. Favorable & unfavorable fractures.
Answer:

Favourable Fractures:

  • It is one in which the fracture lines run in such a way that the forces of the muscles bring the fracture frag ments closer instead of displacing them
  • It can be horizontal or vertical depending in the direction they are viewed
  • If it is viewed from lateral surface of the mandible, it is horizontal
  • If it is viewed from the occlusal surface, it is vertical

Unfavorable Fractures:

  • It is one in which the fracture line runs in such a way that the muscle forces tend to displace the fragments away from each other
  • It can also be horizontal or vertical depending in the direction they are viewed
  • If it is viewed from the lateral surface of the mandible, it is horizontal
  • If it is viewed from the occlusal surface, it is vertical

Maxillofacial Trauma Vertically Favourable Fracture

Maxillofacial Trauma Vertically Unfavourable Fracture

 

Maxillofacial Trauma Horizontally Favourable Fracture

Maxillofacial Trauma Horizontally Unfavourable Fracture

Maxillofacial Trauma Sublingual Ecchymosis

Question 6. Pathological fractures.
Answer:

Pathological fractures

Occurring due to underlying disease

  1. Tumors:
    • Giant cell tumor
    • Bone cysts
  2. Infections:
    • Acute osteomyelitis
  3. Metabolic bone diseases:
    • Hyperparathyroidism
    • Osteoporosis
    • Paget’s disease

Question 7. Wire osteosynthesis.
Answer:

Wire osteosynthesis

It is nonrigid method of fixation

Technique of Wire osteosynthesis:

  • Drilling of holes on either side of the fracture line
  • Passing wire through each hole
  • Prevent damage to nerves
  • Bring both ends of the wires to the buccal surface
  • Twist them together
  • Cut & tuck them
  • Irrigate the wound
  • Retain the wires permanently
  • IMF done

Question 8. Nonunion.
Answer:

Nonunion

Lack of bony fusion of fractured ends

  • Etiology of Nonunion:
    • Inadequate fixation
    • Infection of the fracture
    • Lack of adequate blood supply
    • Excessive periosteal stripping
    • Pathological fractures
  • Features of Nonunion:
    • Pain
    • Difficulty in occlusion
    • Difficulty in mastication
    • Abnormality mobility of fractured fragments
  • Radiological Feature:
    • The gap between the fragments
  • Management of Nonunion:
    • Expose the site
    • Graft the space
    • Stabilize the fractured ends
    • Fixation
    • Immobilization

Question 9. Complications of fracture.
Answer:

1. Early complications:

  •  Local:
    • Hemorrhage- Internal or external
    • Damage to vital structures
    • Damage to surrounding tissues, nerves or skin
    • Haemarthrosis
  • Systemic complications:
    • Fat embolism:
      • Features
      • Sudden onset dyspnoea
      • Hypoxia
      • Fever
      • Confusion, coma, convulsions
      • Translent red-brown petechial rash affecting
    • Shock
    • Thromboembolism
    • Pneumonia

2. Late complications:

  • Local complications:
    • Delayed union
    • Non-union
    • When no signs of healing occur after 3-6 months it is called non-union
    • Features:
      • Pain at the fracture site
      • Non-use of extremity
      • Tenderness and swelling
      • Joint stiffness
    • Malunion:
    • Myositis ossificans:
      • Calcifications and bony masses develop within the muscle
      • Presents as pain, tenderness, focal swelling, and joint/muscle contractions
  • Systemic complications:
    • Gangrene, tetanus, septicaemia
    • Osteoarthritis

Maxillofacial Trauma Short Question And Answers

Question 1. Cap splint.
Answer:

Uses of Cap Splint:

  • Fixation of fractures
  • Fracture of the mandible in children
  • Fracture of the edentulous mandible

Technique of :

  • Impression of upper & lower arches
  • Fabrication of cast & splint
  • Reduction of fragments
  • The casting of the splint
  • Cementation of splint over occlusal surfaces of teeth

Question 2. Battle’s sign.
Answer:

Battle’s sign

  1. Location: Mastoid region
  2. Cause: Condylar fracture
  3. Feature: Ecchymosis in the pre-auricular region

Question 3. Bone plate.
Answer:

Bone plate

  • The semirigid type of fixation
  • Depending on the fracture bone plates are fixed

The technique of Bone plate:

  • Incision
  • Exposure of fracture site
  • Reduction of fracture
  • Adaptation of bone plates
  • Fixation with the help of screws

Question 4. Subconjunctival ecchymosis.
Answer:

Subconjunctival ecchymosis

  • Fracture of orbital walls
  • Subperiosteal hemorrhage
  • Destruction of the periosteum of orbit
  • Leads to subconjunctival hemorrhage
  • Appears bright red in color due to the diffusion of oxygen

Question 5. Lag screw.
Answer:

Lag screw

  • Introduced by Brons & Boring in 1970
  • It is a long screw driven into both sides of the fractured bone

Mechanism of Lag screw:

  • As the screw is tightened, fractured ends are brought together
  • Thus closes the space between them

The technique of Lag screw:

  • Drilling of gliding hole in the proximal fragment
  • Drilling of traction hole in distal fragment
  • Engaging screw
  • Tightening it
  • Results in pulling of distal fragment through threads & proximal fragment by screw head

Maxillofacial Trauma Lag Screw Fixation Gliding hole Through Proximal segment Larger Than Diameter Of Screw

Question 6. Blow-out fracture.
Answer:

Blow-out fracture

Occurs when the object of diameter greater than the diameter of the object strikes

Pathogenesis of Blow – out fracture:

  • Fracture of the floor of the orbit
  • Herniation of fat into antral cavity Increase in orbital volume
  • Enophthalmos

Features of Blow – out fracture:

  • Enophthalmos
  • Entrapment of muscles of orbit
  • Restricted movement of orbit
  • Diplopia
  • Subconjunctival hemorrhage
  • Paraesthesia
  • Circumorbital edema
  • Ecchymosis

Maxillofacial Trauma Blow Out Fracture Of the Floor Of The Orbit

Question 7. Dento alveolar fractures.
Answer :

Features of Dento alveolar:

  • Mobility of dentoalveolar segment
  • Subluxation on avulsion of teeth
  • Splitting of teeth
  • Occlusal derangement
  • Laceration of gingiva

Management of Dento alveolar:

  • Reduction of segment Occlusion correction
  • Stabilizing with wiring
  • Soft diet for 3 weeks

Question 8. Enophthalmos.
Answer:

Enophthalmos

It is inward sinking of the eye

Causes of Enophthalmos:

  • Decrease in the orbital volume due to herniation of orbital fat
  • Increase in bony orbit due to fracture of its walls
  • Loss of ligament
  • Post traumatic fibrosis
  • Combination of above

Clinical Features of Enophthalmos:

  • Hooding of upper eyelid
  • Anterior projection of globe

Treatment of Enophthalmos:

  • Surgical intervention
  • Placing materials behind the globe

Question 9. Gunshot injuries.
Answer:

Gunshot injuries

These are penetrating wounds

Classification of Gunshot injuries:

  • Penetrating wounds: missile is retained in wound
  • Perforating wounds: Missile exits from another wound
  • Avulsive wound: Large amount of structure is destroyed

Etiology of Gunshot injuries:

  • High velocity bullets
  • Low velocity projectiles

Question 10. Geurin’s sign.
Answer:

Geurin’s sign

  • Location: In the region of greater palatine foramen
  • Cause: Lefort 1 fracture
  • Feature: Ecchymosis in the greater palatine foramen

Question 11. Coleman’s sign.
Answer:

Coleman’s sign

  • Location: Floor of the mouth
  • Cause:
    • Blow in the chin
    • Base of skull fracture
    • Mandibular fracture
  • Feature: Ecchymosis in the floor of the mouth

Question 12. Black eye.
Answer:

Black eye

Feature of Lefort II fracture

  • Appearance of Black eye:
    • Presence of bilateral circumorbital edema
    • Presense of bilateral circumorbital ecchymosis
  • Diagnosis of Black eye: Difficult due to rapid development of swelling of eyelids

Question 13. Gunning splints.
Answer:

Gunning splints

Gunning splints are retained in position by circumfer ential wiring or by peralveolar wiring,

  • Indication of Gunning splints:
    • Fracture of edentulous mandible
  • Contraindications of Gunning splints:
    • Unfavourable fracture lying outside the denture bear- ing area
    • Severe fracture displacement
  • Construction of Gunning splints:
    • Upper and lower impressions are made
    • Casts are poured
    • Upper and lower base plates are adapted
    • Bite blocks are prepared only in posterior resgion
    • Hooks are incorporated over buccal side of the blocks Grooves are made over canine region to prevent the peralveolar and circumferential wires from slipping along the surface of the splint

Question 14. Epistaxis.
Answer:

Epistaxis

It is defined as bleeding from the nose

Causes of Epitaxis:

Maxillofacial Trauma Epitaxis Causes

Maxillofacial Trauma Viva Voce

  1. The most common site of fracture of the mandible is the angle
  2. The Lefort I fracture is a transverse fracture of the maxilla
  3. Dish face deformity is commonly seen with a fracture of the middle third of face
  4. Fractures of the coronoid process can occur due to reflex muscular contraction
  5. The optimum length of the screw for fixation of the plate in the mandible is 4 mm
  6. The contraindication to miniplate along the line of osteosynthesis would be a fracture in a 10 years old
  7. Glasgow coma scale is used to ascertain level of consciousness
  8. The best radiographic view for examination of fracture of the middle face is Water’s view
  9. Geurin sign is the presence of ecchymosis at the greater palatine foramen area
  10. The golden hour of trauma refers to the period of time exactly one hour after the trauma is sustained
  11. Corman’s sign is ecchymosis in the lingual sulcus
  12. Verill’s sign includes eyelid ptosis, blurring of vision, and slurring of speech
  13. The inferior dental nerve is frequently damaged in fractures of the body and the angle of the mandible
  14. Lefort I fractures mainly involves the tooth-bearing area of the maxilla
  15. Lefort II involves maxilla, nasal and lacrimal bones
  16. Lefort III involves maxilla, lacrimal, nasal and ethamoidal bones
  17. The maxillary incisor region is a common site of dental fractures
  18. Cracked pot sound on percussion is seen in alveolar fractures
  19. Lag screws are used to immobilize oblique fractures
  20. The use of acrylic cap splints with circumferential wiring is best method to treat mandibular fractures in children.

Maxilofacial Surgery Miscellaneous Question And Answers

by

Maxillofacial Surgery Miscellaneous Short Essays

Question 1. TNM Staging.
Answer:

TNM Staging

  •  T Size of the tumor
  • N lymph node involvement
  • M distant metastasis

Miscellaneous Staging

  • T0N0 tumor present
  • This carcinoma in situ
  • T1 Tumour 2 cm or less
  • T2 Tumour between 2-4 cm
  • T3 Tumour more than 4 cm
  • T4 Tumour invading adjacent structures
  • N0 No node involvement
  • N1 ipsilateral lymph node involvement of 3 cm or less
  • N2 ipsilateral lymph node involvement of more than 3 cm or less than 6 cm
  • N3 Contralateral node involvement
  • M0 no metastasis
  • M1 metastasis present

Question 2. Cryosurgery.
Answer:

Cryosurgery

  • Introduced by Barnard
  • Temperature: 20 degrees to -180 degrees

Apparatus of Cryosurgery:

  • Cylinder carrying gases No or CO2
  • Probe
  • The cord connecting the above two

Technique of Cryosurgery:

  • Anesthetize the area
  • Freeze the exposed nerve for 2 min
  • Thaw it for 5 min
  • Freeze is next for 3 minutes

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

Effects of Cryosurgery: 

  • Dehydration
  • Denaturation pf lipid molicules
  • Necrosis of tissues, capillaries, small arterioles and venules

Question 3. Champy’s osteosynthesis lines.
Or
Champy’s Lines
Answer:

Champy’s osteosynthesis lines

Introduced by Champy et al in France

  • He advocated the use of small, thin malleable stainless steel plates used with monocortical screws, placed in specific areas in the mandible.
  • The masticatory forces that are produced during the functional loading of the manciple produce a natural strain of compression along the lower border of the mandible
  • Champy found that these are ideal osteosynthesis lines of the mandible
  • Miniplates with monocortical screws must be placed only along these lines in the region of fracture to achieve maximum stability.

Factors Considered of Champy’s Osteosynthesis:

  • Thickness of bone
  • Position of the inferior alveolar canal
  • Root apices

Miscellaneous Champys Osteosynthesis

Lines of Champy’s osteosynthesis:

  • Superolateral aspect along the external oblique ridge
  • Inferior border of the mandible

Question 4. Antibiotics for oral infection.
Answer:

Antibiotics for oral infection:

Miscellaneous Antibiotics Of Oral Infections

Question 5. Antiseptics.
Answer:

Antiseptics: It is a chemical that is applied to living tissues such as mucous membranes to reduce the number of microorganisms present, through inhibition of their activity

Requirements of Antiseptics:

  • A broad spectrum of activity
  • Fast acting
  • Not affected by physical factors
  • Nontoxic
  • Surface compactable
  • Easy to use
  • Odourless
  • Economical

Agents of Antiseptics:

  • Alcohols: Ethyl alcohol
  • Iodophorspovidone iodine
  • The hepatitis virus is not susceptible to it
  • Formulated as 1% iodine solution
  • Not stable at high temperature
  • Hexachlorophene
  • Toxic
  • Used in patients who are sensitive to iodine
  • Chlorhexidine0.075%

Question 6. Syncope diagnosis and management.
Answer:

Predisposing Factors of Syncope:

  • Pain
  • Anxiety
  • Fatigue
  • Fasting
  • Upright position
  • Sight of instruments
  • Sight of blood

Presentation of Syncope:

  • Feeling of warmth
  • Sweating
  • Dilated pupils
  • Cold extremities
  • Bradycardia
  • Dizziness
  • Loss of consciousness

Management of Syncope:

  • Loosening of clothes
  • Monitor vital signs
  • Place cotton soaked in ammonia near the patient’s nose
  • Reassure the patient
  • Discharge the patient on that day

Question 7. Indication for blood transfusion.
Answer:

Indication for blood transfusion

  • Acute hemorrhage
  • Major road accidents
  • Chronic blood loss
  • Preoperatively
  • Intraoperatively
  • In severe malnutrition
  • In erythroblastosis fetal
  • In anaemic patients
  • Postoperatively
  • During chemotherapy in malignancies

Question 8. Medical emergency drug tray.
Answer:

Primary Emergency Drugs:

1. Injectable:

  • Anaphylactic: Epinephrine 0.3-0.5 ml of 1: 1000 IM
  • Antiallergic: Chlorpheramine malate10 mg/ml

2. Noninjectable:

  • Oxygen 1-liter cylinder
  • Vasodilator
  • Nitroglycerine 0.4 mg sublingually
  • Antihyperglycemic
  • Dextrosebolus form

Secondary Emergency Drugs:

1. Injectable:

  • Anticonvulsant: Diazepam5 mg/ml
  • Analgesic: Meperidine 10 mg/ml
  • Vasopressor: Phenylephrine 10 mg/ml
  • Corticosteroid: Dexamethasone50 mg/ml

2. Non injectable:

  • Respiratory stimulant
  • Ammonia 0.3 ml/vaprole

Question 9. Cardiac arrest.
Answer:

Cardiac arrest

It is an emergency

Management of Cardiac arrest:

  • It includes ABC

1. Airway maintenance:

  • The airway is kept patent
  • Steps
    1.  Head tilt:
      • Place the palm on the patient’s forehead
      • Other to support the patient’s neck
      • Tilt the head backward
    2. Chin lift:
      • Place hand over the bony chin
      • Pull the mandible forward
    3.  Jaw thrust:

2. Breathing:

  • Mouth-to-mouth respiration Mouth-to-nose respiration
  • To inflate the lungs
  • Monitor vital signs
  • Check carotid pulse
  • If absent, cardiac massage

3. Circulation:

  • Through external cardiac compression
  • Apply pressure over the lower half of the adult sternum

Effects of Cardiac arrest:

  • Increased pressure within the thorax
  • Increased cardiac output

Question 10. Significance of liver failure.
Answer:

Significance of liver failure

  • Drugs play an important role in surgery
  • They are either preoperatively intraoperatively or postoperatively
  • These undergoes metabolism
  • Thereby reaching the target site
  • Many drugs are synthesis in the liver
  • Thus liver plays an important role
  • If the patient is suffering from liver failure drugs cannot reach the target site
  • Hence its action is hampered
  • Also, the liver plays an important role in the synthesis of many Vitamins
  • As vitamins are essential nutrients in our diet, the liver plays an important role in

Question 11. Radiolucent lesions of angle of mandible.
Answer:

Radiolucent lesions of angle of mandible

It includes

1. Ameloblastoma:

Clinical Features of Ameloblastoma:

  • Swelling & pain in the region
  • Inflammation
  • Tension.
  • Dental trauma
  • Ulceration of mucosa
  • Loosening of teeth
  • Epistaxis
  • Nasal obstruction

Radiological Features of Ameloblastoma:

  • Unilocular or multi locular radiolucency
  • Soap bubble appearance of the lesion
  • Border is clear
  • Resorption of the teeth

2. Dentigerous cyst:

Clinical Features of Dentigerous cyst:

  • Sex: Common in males
  • Age: 1st& 3rd decade
  • Site: Mandibular 3rd molar, maxillary canines, maxillary 3rd molar
  • Expansion of bone
  • Facial asymmetry
  • Displacement of adjacent teeth.
  • Resorption of adjacent teeth

Radiological Features of Dentigerous Cyst:

  • The unilocular, well-defined radiolucency
  • Marginssclerotic

Types of Dentigerous Cyst:

  • Centralcovering the crown of an unerupted tooth
  • Circumferentialcovering the crown from all sides
  • Lateralcovering crown from side

Odontogenic Keratocyst:

1. Clinical Features of Odontogenic Keratocyst:

  • Asymptomatic
  • If secondary infected, causes expansion of cortical plates
  • Mobility of teeth
  • Pain & tenderness of the site

2. Radiological Feature of Odontogenic Keratocyst:

  • Unilocular or multilocular radiolucency
  • Margins: Well-defined sclerotic margins
  • Expansion of cortical plates
  • Soap bubble appearance

Question 12. Dry socket.
Answer:

Definition of Dry socket:

It is focal osteomyelitis of the tooth socket in which the blood clot has disintegrated or been lost

Other Names of Dry Socket:

  • Fibrinolytic alveolitis
  • Alveolar osteitis
  • Alveolar osteomyelitis

Etiology of Dry Socket:

1. Born’s hypothesis:

Miscellaneous Dry Socket Of Brins Hypothesis

2. Nitzan’s theory:

  • States that there is a possible relationship between the fibrinolytic activity of anaerobic bacteria & dry socket

Pre-Disposing Factors of Dry Socket:

  • Infection
  • Decreased blood supply
  • Debilitating conditions

Clinical Features of Dry Socket:

  • Loss of blood clot
  • Bare of granulation tissue
  • Radiating pain
  • Foul odor
  • Metallic taste

Management of Dry Socket:

  • Irrigation of socket
  • Smoothening of bony margins
  • Packing with pom pom
  • Analgesics
  • Hot saline mouth bath
  • Chemical cauterization Regular follow-up

Question 13. Indications of laser therapy.
Answer:

Indications of laser therapy

  • Incision
  • Excision
  • Biopsy of cystic lesions
  • Vaporise excess tissue
  • Frenectomy
  • Remove/reduce hyperplastic tissues
  • Hemostatic
  • In the treatment of Hemangioma

Question 14. Von Willebrands disease.
Answer:

Von Willebrands disease

Deficiency of Factor VIII von Willebrand factor

Clinical Features of Von Willebrands:

  • Epitaxis
  • Menorrheoa
  • Bleeding followed by minor trauma

Lab Investigations of Von Willebrands:

  • Bleeding time increased
  • Prothrombin time – normal
  • 8th  Creduced
  • ve reduced

Treatment of Von Willebrands:

  • Administration of vasopressin
  • 6th infusion of factor 8th
  • Administration of von Willebrand factor
  • Avoid cryoprecipitate

Question 15. Root in the antrum.
Answer:

Root in antrum

Commonly Affected Teeth: Maxillary first molar

Causes of Root in Antrum:

  • Improper grip over force
  • Excessive application of forces
  • A sudden movement of the patient
  • Slippage of root

Pathogenesis of Root in Antrum:

  • The root piece slips as an orange seed
  • An attempt to remove it leads to deep penetration of it

Treatment of Root in Antrum:

  • If it small piece, it exhales out
  • If a large root piece is fractured, it leads to oro antral fistula

Management Caldwell Luc Operation:

  • Procedure:
    • Anesthetized
    • The semilunar incision is given in the mesiobuccal fold in the canine region
    • Reflection of flap
    • Creation of window
    • Removal of sinus lining for biopsy
    • Antrostomy
    • Packing the sinus cavity through ribbon gauze pregnant in benzoin
    • Smoothening of bony margins
    • Replace the flap
    • Suturing

Miscellaneous Intraoral Incision Of Cald Well Luc

Miscellaneous Creation Of Bony Window Drill

Miscellaneous Enlarging Bony Of Window Of Anterior MAxillary

Miscellaneous Reforation Area For Window

Question 16. Analgesics.
Or
Opioid Analgesics
Answer:

Analgesics

  • It is a drug which relieves pain without loss of consciousness
  • It only affords symptomatic relief from pain without affecting the cause

Classes of Analgesics:

1. Opioids Example: Morphine:

  • It is abused

Actions of Opioids:

  • Analgesic
  • Sedative
  • Hypnotic
  • Respiratory depressant
  • Depresses cough center
  • Emetic
  • Miotic
  • Stimulates vagal center
  • Produces convulsants

Contraindications of Opioids:

  • COPD
  • Branchial asthma
  • Head injuries
  • Hypovolaemic shock

2. Nonopioids Example: Aspirin:

Actions of Nonopioids:

  • Analgesia
  • Antipyretic
  • Anti-inflammatory
  • Antiplatelet action

Uses of Nonopioids:

  • Toothache
  • Arthralgia
  • Fever
  • Anti-inflammatory
  • Osteoarthritis
  • Post myocardial infarction
  • Locally as a keratolytic agent

Question 17. Hemophilia.
Answer:

Hemophilia

Bleeding disorder occurring due to X-linked genetic disorder

Types of Hemophilia:

  • Hemophilia A
  • Hemophilia B
  • Von Willebrand disease

Clinical Features of Hemophilia :

  • Easy bruising
  • Prolonged bleeding
  • Soft tissue hemartoma
  • Epistaxis
  • Gastric hemorrhage Recurrent hemarthrosis
  • Joint deformity
  • Spontaneous hematuria
  • Intracranial hemorrhage

Oral Manifestation of Hemophilia:

  • Bleeding gums
  • Bleeding followed by nerve block
  • Recurrent subcutaneous hematoma
  • High caries index
  • Oropharyngeal bleeding

Lab Investigation of Hemophilia:

  • Prolonged clotting time
  • Prothrombin consumption decreased
  • Thromboplastin generation increased

Complications of Hemophilia:

  • Airway obstruction
  • Intestinal obstruction
  • Intracranial bleeding
  • Paralysis
  • Death

Treatment of Hemophilia:

  • Immediate transfusion of factor 8 or 9 Transfusion of packed RBC
  • Control bleeding with the help of fibrin foam
  • Analgesics & corticosteroids
  • Joint immobilization
  • Local chilling
  • Use of 4 desmopressin

Question 18. Antibiotic prophylactic.
Or
OpharyngealEndocarditis prophylaxis.
Answer:

Prophylaxis required for:

  • Dental extraction
  • Periodontal surgeries
  • Endodontic procedures beyond the apex
  • Dental implant placement
  • Subgingival placement
  • Intraligamentary injections

Prophylactic not required for:

  • Restorative dentistry
  • Non intraligamentary injection
  • Placement of rubber dam
  • Placement of removable appliances
  • Suture removal
  • Making impressions
  • Shedding of primary teeth

Question 19. Blood groups.
Answer:

Major blood groups:

  • ABO system
  • Rh system
  • ABO system

Miscellaneous Blood Groups

Rhesus System:

  • This blood group contains the D antigen
  • Individuals who are D-positive are considered Rh-positive
  • Individuals with D negative are Rh-negative

Minor Blood Groups:

  • Lewis system
  • P system
  • I system
  • MNS system
  • Kell & Duffy system
  • Luthern system

Question 20. Tooth Transplantation.
Answer:

Tooth Transplantation

It is the removal of a tooth from one socket & transplanting into another socket

The technique of Tooth Transplantation:

  • Asepsis should be followed
  • The socket of the transplanted site is curetted & irrigated with saline
  • The tooth is placed gently in the socket with light finger pressure
  • Check with a radiograph
  • Placement of splint
  • Prescribe analgesic & antibiotic
  • Check after 24 hours

Question 21. Post-injection hematoma.
Answer:

Post-injection hematoma

  • Injury to any blood vessel may result in the escape of blood into extravascular spaces resulting in a hematoma
  • Occurs after inferior alveolar nerve block & posterior superior alveolar nerve block

Features of Post injection:

  • Intraoral swelling, trismus after inferior alveolar nerve block
  • Extraoral swelling After posterior superior alveolar nerve block

Management of Post injection:

  • Immediate management: Pressure application
  • It resolves itself within 7 – 14 days
  • Antibiotics for a large hematoma
  • After 1-2 days of fomentation

Question 22. Shock-septic.
Answer:

Definition of Shock-septic:

When acute cardiovascular failure is superimposed on bacteremia, it is called septic shock

Clinical Features of Shock-septic:

  • Fever
  • Tachycardia
  • Tachypnea
  • Respiratory alkalosis
  • Hypoxaemia
  • Hypotension
  • Oliguria
  • Icterus

Pathogenesis of Shock-septic:

  • Low cardiac filling
  • Decreased vascular resistance

Results of Shock-septic:

  • Hypovolaemia
  • Myocardial depression
  • Abnormal distribution of blood flow

Management of Shock-septic:

  • Administration of oxygen
  • Removal of the septic nidus
  • Empirical antibiotics
  • Vasoactive drugs: Phenoxybenzamine
  • Inotropic agents: Dopamine
  • Corticosteroids: Prednisolone15 mg/kg
  • Mechanical ventilation
  • Fluid replacement

Question 23. Anaerobic antimicrobial.
Answer:

Anaerobic antimicrobial

  • Metronidazole is the drug of choice
  • It is nitromidazole deravitive

Mechanism of Anaerobic Antimicrobial:

Micro-organism reduces its nitro group & converts it into a cytotoxic drug which damages DNA & inhibits protein synthesis

Uses of Anaerobic Antimicrobial:

  • Orodental infection
  • AUG
  • Periodontitis
  • Pericoronitis
  • Peptic ulcer
  • Amoebiasis
  • Liver abscess

Adverse Reactions of Anaerobic Antimicrobial:

  • Anorexia
  • Metallic taste
  • Headache, dizziness
  • Glossitis
  • Dryness of mouth
  • Peripheral neuropathy

Contraindications of Anaerobic Antimicrobial:

  • Neurological disease
  • Blood dyscrasias
  • The first trimester of pregnancy
  • Chronic alcoholism
  • Dose: 200-400 mg TDS

Question 24. Diclofenac sodium.
Answer:

Diclofenac sodium

  • It is an aryl acetic acid derivative
  • It is an analgesic antipyretic & anti-inflammatory drug

Mechanism of Diclofenac sodium:

  • Inhibits PG synthesis
  • Short-lasting anti-platelet action
  • Neutrophil chemotaxis & superoxide production at
  • Inflammatory sites are reduced

Uses of Diclofenac sodium:

  • Rheumatoid & osteoarthritis
  • Toothache
  • Bursitis
  • Ankylosing spondylitis
  • Dysmenorrhea
  • Post-traumatic & post-operative inflammatory conditions

Adverse Reactions of Diclofenac sodium:

  • Epigastric pain
  • Headache
  • Dizziness
  • Rashes
  • Dose: 50 mg TDS

Trade Name:

  • Voveran
  • Diclonac
  • Movonac

Question 25. Penicillin.
Answer:

Penicillin

Lactum Antibiotic

Mechanism of Penicillin:

  • Inhibit cell wall synthesis
  • Inhibit transpeptidase thus inhibiting the synthesis of peptidoglycan

Classification of Penicillin:

  • NaturalPenicillin G
  • Semisynthetic
  • Acid resistant – Penicillin 5
  • Penicillin resistant Methicillin
  • Aminopenicillin Ampicillin
  • Antipseudomonal penicillin Carbenicillin

Uses of Penicillin:

  • Orodental infections
  • Syphilis
  • Gonorrhea
  • Streptococcal infections
  • Tetanus
  • Prophylactic Gangrene

 

Uses of pencilin

Adverse Reaction of Penicillin:

  • Hypersensitivity
  • Anaphylaxis
  • Local pain at the site of injection
  • Suprainfection
  • Jarish Herxheimer reaction

Question 26. CSF Rhinorrhoea.
Answer:

CSF Rhinorrhoea

It is typically a high level of Lefort III fracture

Causes of CSF Rhinorrhoea:

  • Dislocation of nasal bone
  • Disruption of cribriform plates
  • Tear of durometer
  • This leads to leakage of CSF

Etiology of CSF Rhinorrhoea:

  1. Congenital encephalocele
  2. Acquired Traumatic
    • Infection
    • Iatrogenic
    • Tumors
  3. Spontaneous Increased intracranial pressure

Sites of CSF Rhinorrhoea:

  • Cribiform plate of ethmoidal roof
  • Sphenoidal sinus
  • Frontal sinus

Clinical Features of CSF Rhinorrhoea:

  • Unilateral watery nasal discharge
  • Headache
  • Visual disturbance
  • Salty taste
  • Positional variation
  • Inflammatory paranasal sinus discharge

Clinical Examination:

  • Tram line effect on the face
  • Clear fluid stream
  • A halo sign is seen in blood fluids
  • Glistening moist nasal mucosa

Diagnosis of CSF Rhinorrhoea:

  • Biochemical test
  • Low protein
  • High glucose
  • Beta trans protein
  • Intratracheal fluorescin
  • Nasal endoscopy Imaging

Treatment of CSF Rhinorrhoea:

  • Conservative
  • Bed rest
  • Head elevation
  • Laxatives
  • Antitussives
  • Subarachnoid drainage
  • Surgical
  • Composite graft

Complications of CSF Rhinorrhoea:

  • Pneumocephalus
  • Tension cephalus
  • Infection
  • Intracranial hypertension
  • Persistent & recurrent CSF leak
  • Post-traumatic CSF cyst

Question 27. Aspirin.
Answer:

Aspirin

Salicylic acid derivative

Actions of Aspirin:

  • Analgesia
  • Anti pyretic
  • Anti-inflammatory
  • Antiplatelet action

Adverse Reactions of Aspirin :

  • GIT upset
  • Allergic reactions
  • Hemolysis
  • Nephrotoxicity
  • Hepatotoxicity
  • Reye’s syndrome

Uses of Aspirin:

  • Toothache
  • Arthralgia
  • Fever
  • Anti-inflammatory
  • Osteoarthritis
  • Post myocardial infarction
  • Locally as a keratolytic agent

Question 28. Healing of extraction wound.
Answer:

Immediate Reaction of extraction wound:

  • Coagulation of blood
  • Entrapment of RBC into fibrin mesh
  • Vasodilation & engorgement of blood vessels
  • Mobilization of leukocytes
  • Presence of areas of contraction of clot

First Week of extraction wound:

  • Growth of fibroblast into the wound
  • Formation of granulation tissue
  • The proliferation of epithelium at the periphery
  • The osteoblastic activity of alveolar bone
  • Organization of blood clot

Second Week of extraction wound:

  • Penetration of new capillaries into the center of the clot
  • Degeneration of remnants of PDL
  • Fraying of the bony socket
  • Epithelium proliferation at the periphery
  • Fragments of necrotic bone

Third Week of extraction wound:

  • Complete formation of granulation tissue
  • Presence of young trabeculae Early bone formation
  • Remodeling of cortical bone

Fourth Week of extraction wound:

  • Bone filling
  • Healing of crest of the bone

Question 29. Minor oral surgeries in hemophilic & diabetic
Answer:

Hemophilic Patients:

  • Laboratory Investigations
  • Immediate transfusion of factor 8 or 8 Transfusion of packed RBC
  • Control bleeding with the help of fibrin foam Analgesics & corticosteroids
  • Joint immobilization
  • Local chilling
  • Use of  4 desmopressin

Diabetic Patients:

  • Monitor blood & urine glucose
  • Risks:
  • Hyperglycemia
  • Hypoglycemia
  • Delayed wound healing
  • Infection

Management:

  • Check fasting sugar
  • Advice from physician
  • Normal meal before surgery
  • Routine medication before treatment
  • Prophylactic antibiotic to prevent infection
  • Antibiotics are also prescribed after treatment

Question 30. Blood transfusion reactions.
Answer:

Blood transfusion reactions

  1. Simple pyrexial reactions
  2. Allergic reactions
  3. Sensitization to leukocytes & platelets
  4. Major incompatibility
    • Hematuria
    • Pain in loins
    • Fever with chills
    • Oliguria
  5. Transmission of diseases
    • Thrombophlebitis
    • Inflammation of superficial veins
    • Tender cord-like vein
    • Fever
  6. Congestive cardiac failure
    • In chronic anemic patients
  7. DIC
    • Disseminated intravascular coagulation
  8. Adult respiratory distress syndrome

Reactions Caused By Massive Transfusion:

  • Acid-base imbalance
  • Hyperkalaemia
  • Citrate toxicity
  • Hypothermia
  • Failure of coagulation

Question 31. Squamous cell carcinoma of Lip.
Answer:

Clinical Features of Lip:

  • Age/sex: Elderly males
  • Nonhealing ulcer
  • Edge is everted
  • Induration present
  • The floor is covered with slough
  • Bleeding spots present
  • Fix to underlying subcutaneous tissue
  • Cervical lymphadenopathy

Differential Diagnosis of Lip:

  • Keratoacanthoma
  • Ectopic salivary gland tumor
  • Pyogenic granuloma
  • Leukoplakia

Treatment of Lip:

  • Surgery
  • Abbe flap
  • Estlander flap
  • Radiotherapy
  • Dose: 4000-6000 cGy units

Question 32. Management of patient on long-term steroid therapy.
Answer:

Management of patient on long-term steroid therapy

  • Prevention of infection by encouraging the patient to maintain good oral hygiene
  • Advice frequent dental visit
  • Aggressive treatment for acute infections
  • Consult the patient’s physician if adrenal suppression is suspected

Mild Surgeries of steroid therapy:

  • Double the dose of steroids on the day of treatment
  • Return to normal dose on the next day

Moderate Surgeries of steroid therapy:

  • 100 mg of Hydrocortisone before the procedure
  • Half the dose on the following day

Severe Surgeries of steroid therapy:

  • 200 mg Hydrocortisone
  • Half the dose on the following day

Question 33. Ibuprofen.
Answer:

Ibuprofen

Propionic acid derivative

Mechanism of  Ibuprufen:

  • Inhibit PG synthesis
  • Inhibit platelet aggregation
  • Prolongs bleeding time

Uses of Ibuprofen:

  • Analgesia
  • Tooth extraction
  • Fractures
  • Postoperative swelling
  • Dose: 400-600 mg TDS

Trade Name Ibuprufen:

  • Brufen
  • Ibugesic

Question 34. Hemostatic agents.
Answer:

Mechanical of Agents:

  1. Pressure pressure through gauze piece
  2. Use of hemostat
  3. Sutures & ligation
  4. Embolization of the vessels
    • Through steel coils
    • Alcohol foam
    • Gel foam
    • Silicon spheres

Thermal of Agents:

  • Cautery: Transmission of heat by conduction of tissues
  • Electrosurgery: Through induction from electric current
  • Cryosurgery: Temperature used (-20°C) (180°C)
  • Argon beam coagulator: Flow of argon gas is used
  • Laser 

Chemical Agents:

  1. Local agents:
    • Astringents
    • Bone wax
    • Thrombin
    • Gel foam Oxycel
    • Surgicel
  2.  Systemic agents:
    • Whole blood transfusion
    • Platelet-rich plasma
    • Fresh frozen plasma
    • Cryoprecipitate

Question 35. Nerve supply to maxillary teeth.
Answer:

Nerve supply to maxillary teeth

  • Incisors central, lateralAnterior superior alveolar nerve
  • Canine Anterior superior alveolar nerve
  • Premolar – Middle superior alveolar nerve
  • Molars Posterior superior alveolar nerve

Question 36. Cancrum oris.
Answer:

Cancrum oris

  • It is an extensive ulcerative disease of cheek mucosa occurring in malnourished children
  • Precipitating Factors:
  • Malnutrition
  • Major diseases like diphtheria
  • Vincent’s organism

Treatment or Cancrum oris:

  • Ryle’s tube-feeding
  • Improve the nutrition
  • Antibiotics: Metronidazole-400 mg TID for 7-10 days
  • Reconstructive surgery

Complications of Cancrum oris:

  • Fibrosis
  • Septicaemia
  • Restricted jaw movement
  • Death

Question 37. Principles of antibiotic therapy.
Answer:

Principles of antibiotic therapy can be divided into the following groups:

  1. Clinical evaluation and diagnosis for antimicrobial-biological etiology
    • Antibiotics specific for particular organisms should be used
  2. Study of Culture and Sensitivity
    • Causative organisms are cultured and tested against a range of antibiotics for maximum sensitivity
  3. Age of the patient
    • Certain drugs like chloramphenicol may cause serious toxic effects in infants
  4. Pregnancy and neonatal period
    • Many antibiotics cross the placental barrier
    • They should be used only when extremely necessary
  5. Severity of disease
    • Antimicrobial therapy should be considered for patients with established orofacial infections
    • Initially, a bacteriostatic agent should be used
  6. Nature of the drug
    • Preferable to use bacteriocidal drug
  7. Possibility of drug resistance
    • Alternative drugs should be used in such cases
  8. History of previous allergic reaction
    • Alternative drugs should be used in such cases
  9. Risk of toxicity of the drug
    • Patients should be informed about the side effects of the drug
  10. Cost
    • Proper selection of suitable drugs is done
  11. Use of narrow-spectrum antibiotic
    • It minimizes the risk of superinfection

Miscellaneous Short Question And Answers

Question 1. Idiosyncracy.
Answer:

Idiosyncrasy

  • It is genetically determined abnormal reaction
  • Example: Patients with G6PD deficiency
  • In some cases, a person may be sensitive to low doses
  • While in some patients even high doses don’t produce any reactions

Question 2. Fluid & electrolytes.
Answer:

Fluid & electrolytes

  • Body consists of 50-70% liquids & 30-50% solids by weight
  • Liquid varies with age, sex & body habits Infants > adults 80% Vs 60%
  • Males > Females 60% Vs 50%
  • Thin > Obese
  • Out of the total liquid
  • Intracellular water 40%
  • Extracellular portion 20%
  • 5% plasma
  • 15% interstitial fluid

Water Regulation:

  • Water ingested by regulation of thirst center
  • Water excreted by regulation of ADH

Replacement:

  • Fluid requirement during starvation 2ml/kg/hour
  • Maintenance requirement 2mg/kg/hour of surgery
  • Minor surgery 4ml/kg/hour
  • Moderate 6ml/kg/hour
  • Severe -8ml/kg/hour
  • Blood loss is replaced by blood transfusion

Electrolytes:

Miscellaneous Fluid Of Electolyes

Question 3. Neurogenic shock.
Answer:

Pathophysiology of Neurogenic shock :

Miscellaneous Neurogenic Shock

Damage To Organs:

  • Increase in myocardial contractibility

Question 4 . Hyperventilation.
Answer:

Clinical Features of Hyperventilation:

  • Age: 15-40 years
  • Sex common in females

Features of  Hyperventilation:

  • Anniery
  • Paim
  • Increased depth of respiration
  • Excessive exchange of gases in lungs
  • Decreased level of carbon dioxide
  • Increased pH
  • Decreased cerebral blood flow – Hypotension

Management of Hyperventilation:

  • Stop the dental procedure
  • Make the patient comfortable
  • Caver the mouth & nose with a paper bag
  • Ask the patient to breathe

Question 5. Carcinoma in situ.
Answer:

Carcinoma in situ

It is the most severe stage of epithelial dysplasia, which involves the entire thickness of the epithelium with the basement membrane intact

Clinical Features of Carcinoma:

  • Age: Elderly patients
  • Sex: Common in males

Presentation of Carcinoma:

  • Appears as white plaques or ulcerated areas
  • Site: The floor of the mouth, tongue, lip, etc
  • Appears as leukoplakia or erythroplakia

Treatment  of Carcinoma:

  • Surgery
  • Radiotherapy
  • Electrocautery

Question 6. Classification of NSAID/NSAIDs.
Answer:

Nonsteroidal anti-inflammatory drugs are aspirin-type or non-opioid analgesics

Classification of NSAID:

  1. Nonselective COX inhibitors
    • Salicylic acid derivatives
      • Aspirin, sodium salicylate, diflunisal
    • Para-aminophenol derivatives
      • Paracetamol
    • Pyrazolone derivative
      • Phenylbutazone, azapropazone
    • Indole acetic acid derivative
      • Indomethacin. etodolac
    • Arylacetic acid derivative
      • Diclofenac, aciclofenac, ketorolac
    • Propionic acid derivative
      • Ibuprofen, carprofen, naproxen, ketoprofen
    • Anthranilic acids
      • Flufenamic acid, mefanamic acid
    • Oxicams
      • Piroxicam tenoxicam
    • Alkanones
      • Nabumetone
  2. Selective COX-2 inhibitors
    • Nimesulide, celecoxib, rofecoxib

Mechanism Of Action:

  • NSAIDs inhibit prostaglandin synthesis by inhibiting the enzyme cyclo-oxygenase

Question 7. Submucous fibrosis.
Answer:

Submucous fibrosis

It is a pre-cancerous condition

It is characterized by juxta epithelial inflammatory reaction in the oral mucosa followed by a fibro elastic transformation of the lamina propria leading to mucosal atrophy, rigidity & trismus

Etiology of fibrosis:

  • Consumption of red chilies
  • Consumption of areca nuts Nutritional deficiencies Immunological factors
  • Genetic factors

Features of fibrosis:

  • Burning sensation
  • Difficulty in mastication Referred pain in the ear
  • Depapillation of tongue
  • Restricted movement of floor of mouth
  • Shrunken uvula
  • Fibrous bands
  • Restricted mouth opening
  • Stiffness of buccal mucosa

Management of fibrosis:

  • Quit the habit
  • Antioxidant Oxyace1 capsule/ day
  • Multivitamin therapy
  • Sterold Betnovate 0.12%
  • Tumeric application
  • Intralesional injection of Hyaluronidase 1500 U
  • Physiotherapy
  • Splitting of fibrous bands
  • Laser

Question 8. Cherubism.
Answer:

Clinical Features of Cherubism:

  • Painless, bilateral swelling of the mandible
  • Maxillary swelling
  • Pressure on orbit
  • Heavenward look
  • Increased cheek fullness
  • Expansion & widening of the alveolar ridge.
  • Flattening of palatal vault
  • Chronic lymphadenopathy
  • Premature exfoliation of deciduous
  • Delayed eruption of permanent
  • Hypodontia of teeth
  • Difficulty in mastication, speech, swallowing
  • Associated with Noonan syndrome
  • Affects young children

Treatment of Cherubism:

  • Self-limiting disease

Question 9. Diazepam.
Answer:

Diazepam

It is benzodiazepine

Actions of Diazepam:

  • Sedation & hypnosis Reduction in anxiety
  • Muscle relaxant
  • Anticonvulsant
  • Amnesia

Mechanism of Diazepam:

  • Binds to GABA receptor
  • Increases frequency of chloride channel opening Increases flow of chlorine
  • Hyperpolarization

Adverse Reactions of Diazepam:

  • Drowsiness
  • Blurred vision.
  • Amnesia
  • Lethargy
  • Ataxia
  • Tolerance & dependence

Uses of Diazepam:

  • Insomnia
  • Anxiety
  • Anticonvulsants
  • Muscle relaxant
  • Pre-anesthetic medicament
  • During alcohol withdrawal

Question 10. Dead space management.
Answer:

Dead space management

Dead space is a space left in the body as a result of a surgical procedure

Management of Dead space:

  • It depends on size, location, and cause
  • Treatment options are
    1. No treatment
    2. External bandage compression
      • Involves the application of mildly compressive bandages to compress
    3. Suture closure
      • Can avoid post-surgical care and overall cost factors associated with the use of surgical drains
    4. Use of drainage systems
      • Protects wounds
      • Penrose drains are used to control small to moderate-sized areas of dead space
      • Normally used to manage dead space for 3-5 days
    5. Aspiration
      • Hypodermic needle aspiration may be used alone or in combination

Question 11. Enbloc resection.
Answer:

Enbloc resection

  • It is the resection of a large bulky tumor virtually without dissection surgery
  • It is used in certain cancers to remove
  • Primary lesion
  • Contagious draining lymph nodes

Question 12. Papilloma.
Answer:

Papilloma

  • Papilloma is a common benign neoplasm of the oral cavity arising from epithelial tissue
  • It is characterized by exophytic growth with a typical cauliflower-like appearance

Clinical Features of Papilloma:

  • Age- Third, fourth, and fifth decade of life Sex-both sexes are equally affected
  • Site involved
  • Tongue
  • Lips
  • Buccal mucosa
  • Gingiva
  • Hard and soft palate
  • Present as slow growth, exophytic, soft, pedunculated, painless, nodular growth with a cauliflower-like appearance
  • Have numerous finger-like projections over the surface
  • It appears as ovoid swelling with a corrugated surface
  • Size- a few mm to 1 cm in diameter
  • The base of the lesion may be pedunculated or sessile
  • Color-white in color
  • Surface- highly keratinized
  • Superficial ulceration and secondary infection occur
  • Rarely papilloma grows inward

Question 13. Eburnation.
Answer:

Eburnation

  • Eburnation describes a degenerative process of bone commonly found in patients with osteoarthritis or non-union of fractures
  • It is an ivory-like reaction of bone occurring at the site of cartilage erosion
  • Osteoarthritis is a degenerative disease of the joints characterized largely by central loss of cartilage and compensatory peripheral bone formation
  • Over time, as the cartilage wears away and subchondral bone is revealed
  • Eburnation describes the bony sclerosis that occurs in the areas of cartilage loss

Question 14. Nutrition for post-surgical patients.
Answer:

Nutrition for post-surgical patients

Nutrition requirements for post-surgical patients increase than normal requirements

  1. Calorie:
    • Increases to 30-40 kcal/kg
    • Patients on ventilators usually require fewer calories- 20-25 kcal/kg
  2.  Protein:
    • Increases to 1-1.8 grams/kg
  3. Fluids:
    • Start clear liquids when signs of bowel function return
    • Clear liquids are intended for short-term use due to inadequacy
  4. Vitamin supplements:
    • Vitamin supplements promote healing Avoid long-term supplements due to the high risk of toxicity

Minerals of post-surgical patients:

  • Zinc loss occurs due to large wounds, chest tubes, and wound drains
  • Prolonged zinc supplementation interferes with copper absorption

Relining And Rebasing Short Essay Question And Answers

by

Relining And Rebasing

 

Relining And Rebasing Definitions

 Relining: A procedure to resurface the tissue surface of the denture with new base material to make the denture it more accurately

Rebasing: A process of refitting a denture by the replacement of the denture base material

Relining And Rebasing Important Notes

Relining And Rebasing:

Indications of Relining And Rebasing:

  • Immediate dentures at 3-6 months after their original construction
  • When the residual alveolar ridges have resorbed and adaptation of the denture base to the ridge is poor
  • When a patient cannot afford the cost of new dentures
  • Geriatric or chronically ill patients
  • Centric occlusion should coincide with centric relation

Contra-Indications of Relining And Rebasing:

  • An excessive amount of resorption
  • Abused soft tissues are present
  • The patient complains of TMJ problems
  • Dentures have poor esthetics
  • Denture creating speech problems
  • Severe osseous undercuts exists until surgical removal and healing occurs

Relining And Rebasing Short Essays

Question 1. Tissue conditioner.
Answer:

Tissue conditioners are tissue-lining materials

Functions of Tissue conditioner:

  • Permit wider dispersion of forces
  • Aid to decrease the force per unit area transmitted to the supporting tissues
  • Serve as analog of the mucoperiosteum

Composition of Tissue conditioner:

  • Polyethyl methacrylate
  • Aromatic ester
  • Ethyl alcohol

Uses of Tissue conditioner:

  • Tissue treatment
  • Temporary obturator
  • Baseplate stabilization
  • To diagnose the outcome of resilient liners
  • Liners in surgical splints
  • Trial denture base Functional impression material

Question 2. Uses of resilient liners.
Answer:

Uses of resilient liners:

  • Adjuncts for tissue healing
  • Preserve the residual ridge
  • Heal irritated tissue
  • As temporary obturator
  • Done directly in the mouth
  • Or indirectly after making an impression of the surgical site
  • Stabilization of baseplate
  • Used in presence of undercuts to stabilize the denture base and prevent its breakage
  • Diagnosis of the outcome of resilient liner
  • In case of chronic soreness caused by dentures
  • For surgical splint
  • As it is of stiffer consistency
  • As a trial denture base
  • As functional impression material
  • In the presence of movable tissues

Read And Learn More: Prosthodontics Question And Answers

Relining And Rebasing Tissue Conditioner As A Temporary Obturator

Relining And Rebasing Tissue Conditioner While Fabricating A Temporary Denture Base

Question 3. Open mouth relining.
Answer:

Boucher’s Technique:

Relining And Rebasing Boucher's Technique

Relining And Rebasing Articulating The Denture And Plaster Template

Question. 4. Relining & rebasing.
Or
Indications for relining the complete denture.
Answer:

Definition:

Relining:  A procedure to resurface the tissue surface of the denture with new base material to make the denture fit more accurately

Rebasing:  A process of refitting a denture by the replacement of the denture base material

Indications of relining the complete denture:

  • Immediate dentures after 3–6 months
  • Poor adaptation of dentures
  • Economic
  • Old patients

Contraindications of relining the complete denture:

  • Excessive residual ridge resorption
  • Abused soft tissues
  • TMJ problems
  • Dissatisfied patients
  • Abnormal jaw relations
  • Patient having speech defect
  • Presence of severe undercuts

Advantages of relining the complete denture:

  • The need of frequent visits
  • Economic
  • Good fit
  • Incorporation of soft liner possible

Disadvantages of relining the complete denture:

  • Alters jaw relation
  • Impossible to correct jaw relation, aesthetics
  • Impossible to correct occlusal arrangements
  • Not used in dentures with excessive resorption

Question 5. Remounting procedure.
Answer:

Used to refine the occlusion of prosthesis

Purpose of Remounting :

  • Reproduce the relationship of the cast at rest & at function
  • Verify the records
  • Correct processing errors
  • Refine occlusion

Requirements of Remounting :

  • Not weaken the cast
  • Not create undercut
  • Be functional
  • Quick & easy to fabricate
  • Easy to remove
  • Provide 3D fit of the denture

Methods of Remounting :

1. Groove indexing method:

  • Two lines are drawn
  • One line sagittally & other transversely

Relining And Rebasing Groove Indexing

2. Notch indexing method:

  • Notches are created one anterior & 2 posterior

Relining And Rebasing Notch Indexing

3. Split remounting plates for indexing:

  • Male & female remounting plates are used
  • These can be fitted to one another & unlocked with the help of locking pins

Relining And Rebasing Fusing The Male Mounting Plate

Relining And Rebasing Female Mounting Plate

Relining And Rebasing Short Question And Answers

Question 1. Conditioning of abused & irritated tissues.
Answer:

  • Tissue conditioners are used
  • Composition
  • Polymer
  • Monomer
  • Liquid plasticizer

Manipulation of abused:

  • Mixing ratio 1.25 parts polymer, 1 part monomer, 0.5cc plasticizer
  • Mix the ingredients to form a gel
  • Apply sufficient thickness of material to the tissue surface of the denture
  • Insert the denture in the patient’s mouth
  • Carry out border movements

Maintenance of abused:

  • Avoid cleaning with a hard brush
  • Use a soft brush under running water

Question 2. Clinical remounting
Answer:

Clinical remounting is done using interocclusal records

Steps of Clinical remounting:

  • Occlusal surface of the maxillary denture was lubricated with Vaseline and inserted into mouth
  • Two layers of aluwax are placed over posterior teeth in mandibular fixed partial denture
  • Wax is sealed to the denture
  • A mandibular fixed denture is inserted in the mouth and the mandible is guided into centric relation
  • Next patient is asked to close his mouth such that maxillary teeth penetrate about 1-1.5 mm deep into the wax
  • Dentures are removed
  • They are reinserted and the process is repeated with complete closure
  • A maxillary denture is mounted on the articulator using a remount cast
  • A mandibular denture is repositioned against the articulated maxillary denture using a centric record and articulated

Question 3. Functional relining technique.
Answer:

Functional relining technique:

  • Suggested by Winkler
  • The patient is advised to avoid nightwear of the denture
  • Occlusal correction is carried out
  • Overextension of the denture are corrected
  • The tissue surface is reduced
  • The tissue conditioning material is placed
  • A denture is inserted in patient’s mouth
  • Impression is removed
  • Trim the excess material
  • The denture is inserted
  • Recall the patient after 3 to 5 days
  • Examine the depressed areas and renew the material
  • The impression is next made with ZOE and the cast is poured

Relining And Rebasing Reducing The Tissue Surface

Relining And Rebasing Making The Tissue Conditioner Impression

Relining And Rebasing Making The Trimming Excess Impression

Question 4. Instructions for patients in care & maintenance of tissue conditioners.
Answer:

Instructions for patients in care & maintenance of tissue conditioners:

  • Tissue conditioners should not be cleaned by scrubbing with a hard brush to prevent tearing of material
  • The use of soft brush under running water should be done
  • They tend to harden and roughen within 4 to 8 weeks due to the loss of plasticizers
  • Hence, periodic visits should be carried out

Relining And Rebasing Viva Voce

1. Elastic stage of the tissue conditioner is reached in 1- 2 weeks

Special Complete Dentures Short And Long Essay Question And Answers

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Special Complete Dentures

 

Special Complete Dentures Definitions

Tooth-supported over denture:

“A dental prosthesis that replaces the lost or missing natural dentition & associated structures of the maxilla &/or mandible & receives partial support & stability from one or more modified natural teeth”

Special Complete Dentures Important Notes

Disadvantages of immediate dentures:

  • The fit, appearance or comfort is difficult to predict
  • There is no try in
  • Often require tissue conditioner during the healing phase
  • Need a definite reline

Advantages of immediate dentures:

  • Patient’s appearance is maintained
  • Circumboreal support, muscle tone, the vertical dimension of occlusion, jaw relationship and face height can be maintained
  • The tongue will not spread due to the loss of teeth
  • Less post-operative pain
  • Easier to duplicate the natural tooth shape and position
  • The patient is likely to adapt more easily to dentures

The treatment procedure for an immediate denture:

  • The posterior teeth are extracted and allowed to heal
  • Impression and cast are made
  • Anterior teeth on the master cast are broken away and trimmed up to the cervical margin and smoothened.
  • The ridge lap (cervical) portion of the artificial teeth are trimmed and arranged on the master cast.
  • Artificial teeth are arranged over the area where the teeth are to be extracted.
  • The teeth arrangement should be in harmony with the existing teeth as well as the prosthetic teeth.
  • The denture is flashed, dew-axed, packed, processed, and finished.
  • During the insertion appointment, the remaining anterior teeth are extracted as a traumatically as possible, preserving the soft tissue and bone.
  • The finished denture is seated in the patient’s mouth.

Overdentures:

Advantages of Over dentures:

  • Maintains the integrity of the residual ridge
  • Improves stability and support
  • Improved proprioception

If the abutment fails, the over denture can be used as a conventional denture

Types of over dentures:

  • Conventional immediate denture
  • Interim or transitional immediate denture

Special Complete Dentures Long Essays

Question. 1. Define immediate complete denture. Write in detail steps in making it.
Answer:

Definition of immediate complete denture:

“A complete or removable partial denture constructed for insertion immediately following the removal of natural teeth”

Steps of immediate complete denture:

  • Making of alginate impression
  • Duplicating it
  • Pouring of the cast(master cast) for one of the impression
  • It is used for preparing baseplate, rims, jaw relation & teeth arrangement
  • In other impressions pour molten wax into the teeth to be extracted
  • After it cools pour the duplicating cast
  • It is used for processing of dentures
  • Fabricate baseplate & occlusal rims over master cast Record jaw relation
  • Teeth arrangement done over it Try in verification is done
  • Shift the denture to refractory cast Processing of the denture is carried out
  • Atraumatic extraction of the tooth to be done
  • Insertion of an immediate denture

Read And Learn More: Prosthodontics Question And Answers

Special Complete Dentures FillingThe Socketes Of Teeth

Special Complete Dentures Wax Pattern Fabricated Refractory

Special Complete Dentures Extraction Of Teeth

Special Complete Dentures Insertion Of The Immediate Denture

Special Complete Dentures Short Essays

Question 1. Single complete dentures.
Answer:

Types of Single complete dentures:

  • Maxillary complete denture opposing a mandibular natural denture
  • Maxillary complete denture opposing a mandibular partial denture
  • Mandibular complete denture opposing a maxillary natural denture
  • Mandibular complete denture opposing a maxillary partial denture

Indications of Single complete dentures:

  • Inpatient with a jaw discrepancy
  • In cleft patients
  • Retrognathia mandible

Disadvantages of Single complete dentures:

  • Malposed, unerupted teeth interfere with balanced occlusion
  • The presence of lower anterior causes difficulty in aesthetics Acrylic opposing natural teeth causes abrasion of acrylic
  • Porcelain opposing natural teeth causes abrasion of natural teeth

Complications of Single complete dentures:

  • Combination syndrome
  • Wear of natural teeth
  • Fracture of the

Question 2. Problems in single denture construction.
Answer:

  • Malposed, tipped, or supra-erupted teeth in the lower arch will interfere with balanced occlusion
  • It produces soreness, mucosal changes, and ridge resorption in the maxilla
  • Maxillary denture tends to get displaced
  • As lower anterior are present in a fixed position, it is difficult to obtain aesthetic teeth arrangement
  • The use of acrylic teeth opposing natural teeth will produce abrasion of acrylic teeth
  • Use of porcelain teeth opposing natural teeth will produce abrasion of natural teeth

1. Problems in maxillary complete denture opposing mandibular partial denture:

  • Combination syndrome:
    • The patient tends to concentrate the occlusal load on the remaining natural teeth
    • Results in more force acting on anterior portion of the maxillary denture
    • Increased resorption of the anterior part of the maxilla
    • Labial flange will displace and irritate labial vestibule
    • Posteriorly there will be fibrous overgrowth in maxillary tuberosity
  • Wear of natural teeth:
    • Porcelain teeth lead to severe abrasion of opposing natural teeth
    • Denture fracture
    • It occurs due to
    • Excessive anterior occlusal load
    • Deep labial frenal notches
    • High occlusal load

2. Mandibular single denture:

  • It causes severe ridge resorption of edentulous mandible because of
  • Constant movement of the tongue
  • Less denture-bearing area

Question 3. Requirements of overdenture.
Answer:

Requirements of overdenture:

  • Abutment teeth should be surrounded by healthy periodontium
  • Maximum reduction of the coronal portion of tooth Endodontic treatment is required
  • Internal attachment should not be present while tooth preparation
  • Fluoride application
  • Grossly destroyed tooth sleeve coping retainers
  • Attachments for additional retention
  • The motivation of the patient to maintain oral hygiene
  • Recall appointments
  • Regular fluoride application

Patient Selection:

  • Young patient
  • Favourable psychological effect

Abutment Selection:

  • Periodontally sound
  • Cuspids & bicuspids are frequently selected
  • Free of caries
  • Sufficient width of attached gingiva
  • Ideal crown root ratio

Question 4. Tooth-supported complete denture.
Or
Disadvantages of overdentures
Or
Indications & contraindications of over dentures
Answer:

Definition of Tooth-supported complete denture:

“A dental prosthesis that replaces the lost or missing natural dentition & associated structures of the maxilla & or mandible & receives partial support & stability from one or more modified natural teeth”

Special Complete Dentures Tooth Supported Overdenture

Advantages of Tooth-supported complete denture:

  • Maintenance of the integrity of the ridge
  • Improves stability & retention of denture Improves proprioception
  • Avoid psychological effects on patient
  • Universal accepted
  • Can be relined

Disadvantages of Tooth-supported complete denture:

  • Oral hygiene maintenance is required Periodical fluoride application
  • Frequent recall visits are required
  • Expensive
  • Not used in cases with
  • Reduced inter arch space
  • Bony undercuts
  • Periodontal breakdown of the remaining teeth
  • Loss of remaining teeth

Indications of Tooth-supported complete denture:

  • Aesthetics
  • Cleft palate
  • Maxillofacial trauma
  • Worn-out denture Congenital anomalies
  • Abnormal jaw size & position

Contraindications of Tooth-supported complete denture:

  • Poor periodontal status Carious tooth Old age
  • Improper crown root ratio
  • Anterior teeth due to the resorbed alveolar ridge
  • Gingival recession
  • Pupal calcification

Special Complete Dentures Short Question And Answers

Question 1. Advantages of an immediate denture.
Answer:

Special Complete Dentures Advantages Of Immediate Denture
Question 2. Advantages of over dentures
Answer:

  • Maintains the integrity of the residual ridge
  • Improves retention and stability of the denture
  • Improves proprioception
  • Helps in regulating biting force over the denture
  • Has a psychological effect on the patient
  • Can be used universally
  • Even if there is abutment failure, the abutment can be extracted and the over-denture can be relined

Question 3. Types of bar-retained over dentures
Answer:

Types of bar-retained over dentures:

  • This implant treatment involves the placement of 3-4 im- plants and the attachment of a customized bar.
  • This bar provides rigid support through and series of clips to the denture that fits over the top of the bar.
  • The bar retained overdenture treatment can be used in both the upper and lower jaws.
  • It allows the denture to be removed from the mouth for cleaning.
  • Patients also have to brush the bar which remains attached to the implants in the mouth.
  • In the upper arch the bar over the denture often allows for a “horse-shoe design” to be adopted thereby eliminating the denture covering the palate.
  • After the implants have been integrated and the customized bar is fabricated and screw-retained to the lower implants, this bar cannot be removed by the patient and needs to be brushed and cleaned daily just as teeth.
  • The bar provides the retention for the denture which will fit over the top of the bar.

Question 4. The disadvantage of an immediate denture.
Answer:

Disadvantage of an immediate denture

  • Time-consuming
  • Expensive
  • Difficult to record centric relation & occlusion
  • Try in not possible
  • Difficulty in speech & mastication
  • Difficult to adapt to new dentures

Special Complete Dentures Viva Voce

  1. The canine is best over denture abutment
  2. Periodontal disease is the most common cause of loss of abutment in over denture
  3. Regular follow-up examination of over denture is needed at intervals of 3–6 months
  4. 24 hours are necessary to wear immediate denture just after extraction
  5. After 7 days of extraction, an immediate denture can be removed during the night.

 

Implant Dentistry Question And Answers

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Implant Dentistry Definitions

Implant: It is an integral component of the oral implant complex which also consists of supportive bone, interposed kerati- nized and mucosal oral soft tissues and prosthetic superstructure

Splint: Splint is an appliance used for maintaining or stabilizing mobile teeth to their functional position

Osseointegration: It can be defined as “The apparent direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue”.

Implant Dentistry Important Notes

Implant materials:

  • Metals
    • Stainless steel
    • Gold
    • Titanium
    • Tantalum
  • Zirconium
  • Ceramics
  • Calcium phosphate
  • Bioactive and biodegradable ceramics
  • Polymers

Bone healing events after placement of implant:

Implant Dentistry Bone Healing Events After Placement Of Implant

Implant Dentistry Short Essays

Question 1. Splints.
Answer:

Definition of Splints:

Splint is an appliance used for maintaining or stabilizing mobile teeth to their functional position

Functions of Solints:

  • Stabilize mobile teeth to improve patient comfort and provide stability
  • Stabilize moderate to advanced tooth mobility
  • Stabilize teeth in secondary occlusal trauma
  • Stabilize teeth following acute trauma
  • Prevent tipping or drifting of teeth
  • Create adequate stability

Contraindications of Solints:

  • Presence of periodontal inflammation
  • Presence of an insufficient number of non-mobile teeth
  • Presence of inadequate oral hygiene
  • Absence of prior occlusal adjustment

Contraindications of Solints

Read And Learn More: Prosthodontics Question And Answers

Question 2. Parts of implants.
Answer:

  1. Implant body:
    • It is the component that is placed within the bone during the first stage of surgery
    • It can be threaded or non-threaded
  2. Healing screw:
    • During the healing phase, this screw is placed on the superior surface of the body
    • Functions:
      • Facilitates the suturing of soft tissues
      • Prevents the growth of the tissue over the edge of the implant
  3. Healing cap:
    • They are dome-shaped screws placed over the sealing screw after the second stage of surgery
    • Length- 2-10 mm
    • Function:
      • Prevents overgrowth of tissues around the implant
  4. Abutments:
    • It resembles prepared tooth
    • Provides retention to the prosthesis
  5. Impression posts:
    • It facilitates the transfer of the intra-oral location to a similar position on the cast
  6.  Laboratory analogs:
    • It represents the body of the implant
    • Placed on the cast to fabricate an implant-supported prosthesis
  7. Waxing sleeves:
    • Designed to be attached to the body of the implant
  8. Prosthesis retaining screws:
    • Penetrates the fixed restoration and secures it to the abutment

Question 3. Osseointegration/requirements for successful osseointegration.
Answer:

It can be defined as “The apparent direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue”.

Implant Dentistry Osseo Integration

Requirements of osseointegration:

  1. Occlusal load:
    • To develop a strong interface the implant should not be overloaded during its organization period During this period, the surgical area undergoes remodelling process
  2. Biocompatibility:
    • The material used should be biocompatible for example, pure titanium
  3. Implant design:
    • Most conductive design for oseo-integration is cylindrical
  4.  Implant surface:
    • A smooth-surfaced implant is less prone to osseointegration than an implant with mild surface roughness.
  5. Surgical site:
    • It should be healthy
  6. Surgical technique:
    • Site should be subjected to minimal trauma
  7. Infection control:
    • Infection especially from the periodontics should be avoided.

Question 4. Types of Implants.
Answer:

1. Depending on the placement within the tissues:

  • Epiosteal:
    • It receives its primary bone support by resting on it
  • Transosteal:
    • It penetrates both cortical plates
    • It possesses through the entire thickness of the alveolar bone
  • Endosteal:
    • It extends into the basal bone
    • It transects only one cortical bone
    • It is sub-classified into

2. Root form:

  • Used over a vertical column of bone

3. Plate form:

  • Used over a horizontal column of bone

Implant Dentistry Sub Periosteal Dental Implants

Implant Dentistry Transosteal Implants

Implant Dentistry Endosteal Implants

4. Depending on the material used:

  • Metallic implants
  • Non-metallic implants

5. Depending on their reaction to bone:

  • Bio-active (Hydroxyapatite)
  • Bio-inert Implants (metal)

6. Depending on the classification of edentulous spaces:

Implant Dentistry Classification Of Edentulous Spaces

Implant Dentistry Kennedys Class Division B Bone

Implant Dentistry Kennedys Class Division C Bone

Implant Dentistry Kennedys Class Division D Bone

Question 5. Implant materials
Answer:

Implant Dentistry Implant Materials

Implant Dentistry Short Question And Answers

Question 1. Implant
Answer:

It is an integral component of the oral implant complex which also consists of supportive bone, interposed keratinized and mucosal oral soft tissues and prosthetic supra structure

Materials Used of Implant:

  • Metals
    • Stainless steel
    • Tantalum
    • Gold
    • Titanium
  • Zirconium
  • Ceramics
  • Calcium phosphate
  • Bioactive and biodegradable ceramics
  • Polymers

Implant Dentistry Viva Voce

  1. The minimum width of ridge needed for a bio-integrated hydroxyapatite-coated dental implant is 5 mm
  2. The minimum bone height of the ridge needed for a bio-integrated hydroxyapatite-coated dental implant is 8 mm.
  3. 2 mm of space is needed between the implant and the inferior alveolar canal

Maxilofacial Surgery Clinical Topics Question And Answers

by

Clinical Topics Definition

 Local anesthesia: It is loss of sensation in a circumscribed area of the body characterized by depression of excitation of nerve ending & inhibition of the conduction process of peripheral nerve.

Clinical Topics Important Notes

1. Types of nerve blocks:

Clinical Topics Types Of nerve Blocks

2. Inferior nerve block:

  • Areas Anaesthesized:
    • LA is deposited near the main trunk
    • LA is deposited near a large branch of the peripheral nerve
    • LA is deposited near small nerve endings
    • The body of the mandible and the inferior portion of the ramus
    • Mandibular teeth
    • Mucous membrane and underlying tissues anterior to the 1st mandibular molar
  • Complications:
    • Hematoma
    • Trismus
    • Transient facial paralysis

3. Gow Gates technique:

  • It is open mouth technique
  • Landmarks
    • Extraoral
      • The lower border of the tragus
      • Corner of mouth
    • Intraoral
      • Mesiolingual cusp of the maxillary second molar
      • Penetration of needle just distal to maxillary second molar

4. Hematoma:

  • It is commonly associated with a posterior superior alveolar nerve block and inferior nerve block
  • Hematoma formation in the posterior superior alveolar nerve block is due to injury of the pterygoid plex which results in immediate swelling of the face
  • To avoid this short needles are used

5. Extra oral techniques:

  • Maxillary: In this, the needle is directed anterior to the lateral pterygoid plate into the pterygopalatine fossa
  • Mandibular: In it the needle is inserted from below the zygomatic arch and is directed posterior to the lateral pt plate below the foramen ovale

6. Advantages of adding vasoconstrictor agents:

  • Prevents rapid absorption of LA
  • Prolongs the duration of action
  • Reduces the toxicity of LA
  • Bleeding in the area is minimized

7. Composition of LA:

  • Local anesthetic-Ester or amide
  • Vasoconstrictor- Epinephrine
  • Antioxidant- Sodium metabisulphite.
  • It competes with the vasoconstrictor for the available oxygen died to sodium bisulfate
  • Preservative Methylparaben
  • Fungicisde – Thymol
  • Salt- Sodium chloride
  • Vehicle- Distilled water or Ringer’s lactate solution

8. Theories of anesthesia:

  • Surface charge theory
  • Specific receptor theory Acetylcholine theory
  • Membrane expansion theory
  • Calcium displacement theory

9. Theories of pain:

  • Specificity theory
  • Pattern theory
  • Gate control theory

10. Vazirani Akinosi technique:

  • It is closed mouth mandibular nerve block
  • Used in patients with a limited mandibular opening as a result of infection, trauma, or postinjection trismus
  • Nerves anesthetized are
    • Inferior alveolar
    • Incisive
    • Mental
    • Lingual
    • Mylohyoid

Clinical Topics Long Essays

Question 1. Describe the technique of inferior dental nerve block anesthesia. Enumerate complications of the technique.
Answer:

Inferior Alveolar Nerve Block:

  • Nerves anesthetized: Inferior alveolar nerve & its branches
  • Areas to be anesthetized: Mandibular teeth & its supporting tissues

Landmarks of Nerve Block:

  • Mucobuccal fold
  • Anterior border of coronoid process
  • Coronoid notch
  • Pterygomandibular raphe
  • Retromolar pad
  • Retromolar triangle
  • External oblique ridge

The technique of Nerve Block:

  • Position the patient in a semi-reclined position
  • Move your index finger over the mesiobuccal fold up to the external oblique ridge
  • Move it up & down to obtain depression
  • This is a coronoid notch
  • Retract the cheek
  • Support the mandible
  • Insert 1 5/8 inch 25 gauge needle from the lingual side
  • Aspirate & Slowly deposit the solution

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

Positive Aspiration: 10-15%:

  • Symptoms:
    • Subjective: Tingling & numbness over the lower lip & lateral border of the tongue
    • Objective: Instrumentation demonstrates the absence of pain

Complications of Nerve Block: 

  • Trismus
  • Hematoma
  • Transient facial paralysis

Question 2. Describe in detail the surgical anatomy, indications & contraindications & technique of the inferior alveolar nerve block.
Answer:

Surgical Anatomy:

  • It is a branch of the posterior division of the mandibular nerve i.e division of a trigeminal nerve
  • It passes between the medial pterygoid muscle & ramus of the mandible
    Passes through the mandibular foramen
  • On reaching the anterior teeth it divides into incisive & mental branches
  • Before entering into the mandibular foramen it gives out a mylohyoid branch to supply the mylohyoid muscle
  • Inferior Alveolar Nerve Block

Clinical Topics Surgical Anatomy

Indications of Surgical Anatomy:

  • Any surgery related to multiple mandibular teeth
  • Buccal soft tissue anesthesia
  • Lingual soft tissue anesthesia

Contraindications of Surgical Anatomy:

  • Infections
  • Lip biting
  • Young children
  • Physical & mentally handicapped children
  • Nerves anesthetized: Inferior alveolar nerve & its branches
  • Areas to be anesthetized: Mandibular teeth & its supporting tissues

Landmarks of Surgical Anatomy:

  • Mucobuccal fold
  • Anterior border of coronoid process
  • Coronoid notch
  • Pterygomandibular raphe
  • Retromolar pad
  • Retromolar triangle
  • External oblique ridge

The Technique of Surgical Anatomy:

  • Position the patient in a semi-reclined position
  • Move your index finger over the mesiobuccal fold up to the external oblique ridge
  • Move it up & down to obtain depression
  • This is a coronoid notch
  • Retract the cheek
  • Support the mandible
  • Insert 1 5/8 inch 25 gauge needle from the lingual side
  • Aspirate & Slowly deposit the solution
  • Positive Aspiration: 10-15%:

Question 3. Write the course of the maxillary nerve. And write the landmarks for the posterior superior nerve block.
Answer:

Maxillary Nerve:

  • Originates at the middle of the semilunar ganglion
  • Continues in the lower part of the cavernous sinus
  • Passes to the foramen rotundum
  • Enters pterygopalatine fossa
  • Enters the inferior orbital fissure to enter the orbit

Branches of Maxillary Nerve:

1. In middle cranial fossa:

  • Middle meningeal nerve to supply

2. In pterygopalatine fossa:

  • Zygomatic nerve:
    • Passes anteriorly & laterally
    • Divides into
      • Zygomaticofacial nerve- Pierces the orbicular oris & supplies prominence of cheek Zygomaticotemporal nerve
    • Enters the temporal fossa & supplies the skin over the anterior temporal fossa region
  • Pterygopalatine nerve:
    • Branches:
      • Orbital branches: Using inferior orbital fissure, supplies periosteum of orbit, posterior ethmoid cells & sphenoid sinus
      • Nasal branches: Divides into posterior superior lateral & medial or septal branches
  • Palatine branches:
    • Descends in the pterygopalatine canal, divides into
      • Greater or anterior palatine- supply hard palate
      • Middle palatine-sensory to soft palate
  • Posterior palatine:
    • Supplies mucous membrane to tonsil.

3. Posterior superior alveolar nerve:

  • Divides into many branches & descends downward to supply maxillary molars & their supporting gingivae

4. Branches in infraorbital groove & canal: 

  • Middle superior alveolar nerve:
    • Supplies the posterior part of the maxillary sinus
    • Descends downward
    • Divides & supplies maxillary bicuspids

5. Terminal branches on face:

  • Inferior palpebral- Supplies lower eyelid
  • External or lateral nasal –  Supplies side of the nose
  • Superior labial – Supplies upper lip

Clinical Topics Terminal Branches On Face

Clinical Topics Terminal Branches On Face.

Landmarks Of Posterior Superior Alveolar Nerve Block:

  • Zygomatic process of maxilla
  • Mucobuccal fold
  • infratemporal process of maxilla Coronoid process of mandible

Question 4. Enumerate the course of the mandibular branch of the trigeminal nerve & explain the technique of inferior alveolar nerve block.
Answer:

Maxilofacial Surgery Clinical Topics Mandibular nerve
1. Divided nerve:

  • Anterior Division
    • External pterygoid
    • Masseter
    • Temporal
    • Buccal
  • Posterior
    • Inferior alveolar
    • Auriculotemporal
    • Lingual

2. Undivided nerve:

  • Nervus spinosus
  • Internal pterygoid

Inferior Alveolar Nerve Block:

  • Nerves anesthetized: Inferior alveolar nerve & its branches
  • Areas to be anesthetized: Mandibular teeth & its supporting tissues

Landmark of Nerve Block:

  • Mucobuccal fold
  • Anterior border of coronoid process
  • Coronoid notch
  • Pterygomandibular raphe
  • Retromolar pad
  • Retromolar triangle
  • External oblique ridge

The technique of Nerve Block:

  • Position the patient in a semi-reclined position
  • Move your Index finger over the mesiobuccal fold up to the external oblique ridge
  • Move it up & down to obtain depression
  • This is a coronoid notch Retract the cheek
  • Support the mandible
  • Insert 1 5/8 inch 25 gauge needle from the lingual side
  • Aspirate & Slowly deposit the solution
  • Positive Aspiration: 10-15%

Question 5. Describe in detail the extracranial course of the trigeminal nerve.
Answer:

  • The trigeminal nerve is the fifth cranial nerve
  • It divides into three branches as it proceeds from the convex border of the semilunar ganglion.

Branches of Trigeminal nerve :

1. Ophthalmic branch:

  • Passes upward & enters the orbit through the superior orbital fissure
  • It divides into
    • Lacrimal branch- supplying the lacrimal gland
    • Frontal branch- further divides into
      • Supraorbital & Supratrochlear
    • Supplies canthus of eye & side of the face
    • Nasociliary nerve: Divides into

2. Orbital branches:

  • Long ciliary ganglion
  • Long ciliary nerve
  • Posterior ethmoid- Supply posterior ethmoidal cells & sphenoidal sinus
  • Anterior ethmoidal- Supply anterior ethmoidal cells & frontal sinus
  • Divides into internal & external nasal

3.  Nasal branches:

  • Supplies vomer & nasal mucosa

4. Terminal branches on face:

Supplies lower eyelid, upper lip & side of nos

Clinical Topics Terminal Branches On Face And Terminal Nerve

Question 6. Definition, composition & ideal properties of local anesthesia. Describe its mechanism of action.
Answer:

Definition of anesthesia:

It is loss of sensation in a circumscribed area of the body characterized by depression of excitation of nerve endings & inhibition of the conduction process of peripheral nerve

Composition of Anaesthesia:

  • Local anesthetic – Ester or amide
  • Vasoconstrictor- Epinephrine
  • Antioxidant- Sodium metabisulphite
  • Preservative- Methylparaben
  • Vehicle- Distilled water or Ringer’s lactate solution

Ideal Properties of Anaesthesia:

  • Nonirritant
  • No permanent damage to the nerve
  • Low systemic toxicity
  • Effective
  • The short onset of action
  • Long-lasting effect
  • Potent
  • Free of allergens
  • Stable & biocompactible
  • Able to sterilize it

Mechanism Action of Anaesthesia:

  • Displacement of calcium ions from sodium channel receptor site which permits
  • The binding of the LA molecule to this site produces
  • Blockade of the sodium channel & a
  • Decrease in sodium conductance, which leads to
  • Depression of rate of electrical depolarization
  • Failure to achieve the threshold potential level along with a
  • Lack of development of propagated action potential which is called
  • Conduction blockade

Question 7. Classify local anesthetic drugs. Discuss lignocaine hydrochloride.
Answer:

Based on the Site of Action:

  • Class 1: Agents acting on the external surface of the membrane
    • Example: Biotoxins
  • Class 2: Agents acting on the internal surface of the membrane
    • Example: Quaternary ammonium compounds
  • Class 3: Agents acting by an independent mechanism
    • Example: Benzocaine
  • Class 4: Agents acting by combination mechanisms
    • Example: Articaine, Bupivacaine

Based On Group of Drugs:

  1. Esters:
    • Esters of Benzoic Acids:
      • Butacaine
      • Cocaine
      • Hexylcaine
      • Tetracaine
    • Esters of Paraamino Acids:
      • Chloroquine
      • Procaine
  2.  Amides:
    • Atricalno
    • Bupivacaine
    • Etidocaine
  3. Quinolone:
    • Centbucridine

Lidocaine HCL:

  • Classification: Amide
  • Potency: 2
  • Metabolism: Microsomal oxidase
  • PKA: 7,9
  • pH of plain solution:6.5
  • pH of Vasoconstrictor: 5-5.5 Plasma Half-Life 16-hour
  • Effective Concentration: 2%
  • Maximum Recommended Dose: 7 mg/kg body weight

Question 8. Write about it Indications & contra-indications of local anesthesia.
Answer:

Indications anesthesia:

  • Periodontal surgery
  • Extraction
  • Impaction
  • Endodontic procedures Implant placement
  • Minor surgical procedures

Contraindications of anesthesia:

  1. Absolute contraindications:
    • Local anesthetic agent allergy
    • Bisulfite allergy
  2. Relative contraindications:
    • Liver disorders
    • Renal disorders
    • Cardiac disorders
    • Methemoglubenimela

Question 9. Write in detail about local & systemic complications of local anesthesia.
Or
Post Operative complications of LA
Answers:

Local Complications:

1. Needle breakages:

  • Due to the sudden movement of the patient’s Narrow gauge needle
  • Broken needle
  • Bent needle

Management: 

  • Due to the sudden move
  • Radiograph to locate it
  • Expose the site and remove it

2. Facial nerve paralysis  

Causes :

  • Insertion of needle into the parotid capsule

Management: 

  • Self-curing
  • The eye can be protected with the help of a keypad

3. Paraesthesia:

Cause:

  • Injury to the nerve

Management:

  • Self-recovery by regeneration of nerve:

4. Trismus:

Cause:

  • Trauma to medial pterygoid muscle:
  • Contaminated needle

Management:

  • Analgesic
  • Muscle relaxants
  • Hot fomentation
  • Physiotherapy

5. Pain on injection:

Cause:

  • Blunt needle
  • Broader gauge needle

Management:

  • Use of short, narrow-gauge needle

6. Burning on injection:

Cause:

  • An acidic solution of LA
  • Contaminated needle

Management:

  • Isotonic solution by addition of bicarbonate
  • Use of disposable needle

7. Soft tissue injury:

Cause:

  • Due to being unaware of numbness of lips patient tries to do lip-biting

Management:

  • Explain to the patient the numbness
  • Use of lifeguards in children

8. Hematoma:

Cause:

  • Injury to blood vessels

Management:

  • Assure of proper anatomy of landmarks & nerve
  • Massage the area
  • Antibiotics
  • Hot fomentation

9. Infection:

Causes:

  • Contaminated needle

Management:

  • Use of disposable needle
  • Antibiotics
  • Drainage of space involved
  • Physiotherapy

10. Necrosis of tissues:

Causes:

  • Seen in palatal injection
  • This region is tightly bound to the underlying bone
  • Thus excessive pressure is required for the insertion of the needle
  • This leads to the blanching of the area
  • Vasoconstriction & localized necrosis

11. Edema:

Causes:

  • Injury to nerve
  • Contaminated needle

Management:

  • Subsidies on their own
  • Avoid application of hot fomentation
  • Application of cold fomentation
  • As it acts as vasoconstrictor & analgesic

12. Post anaesthetic lesions:

  • Ulcers
  • Allergic reactions

Causes:

  • Trauma
  • Allergy to LA agent

Systemic Complications:

1. Overdose:

Causes of Overdose:

  • Excessive dose of LA
  • Systemic disorders of metabolism

Features of Overdose:

  • Nausea
  • Vomiting
  • Diplopia
  • Tremors
  • Acidosis
  • Respiratory distress
  • Chest pain
  • Bradycardia
  • Hypotension
  • Dizziness

Management of Overdose:

  • Reassure the patient Maintain the patient’s airway
  • Intubate if necessary
  • Cardiac life support given
  • IV fluids & vasopressors were given for hypotension

2. Hypersensitivity:

Causes of Hypersensitivity:

  • Allergy to LA
  • Allergy to preservatives used

Features of Hypersensitivity:

  • Pruritis
  • Utricaria
  • Dyspnoea
  • Wheezing
  • Nausea, vomiting

Management of Hypersensitivity:

  • Stop the procedure
  • Mild allergy- Corticosteroids
  • Severe allergy- Epinephrine 1: 1000 of 0.3-0.5 ml
  • SC If symptoms continue 5 ml of 1: 10000 epinephrine given IV

Question 10.  Discuss the metabolism of ester & amide groups of anesthesia.
Answer:

Metabolism Of Ester Group:

  • Metabolized by hydrolysis by plasma pseudocholinesterase
  • The end product of it is PABA
  • If the patient is allergic to it alternative drug is used
  • Examples- Cocaine, cocaine, etc.

Metabolism of Amide Group:

  • Metabolized in the liver by microsomal enzymes
  • Used with caution in patients with liver disease
  • Example of enzyme: P-450 3A4
  • Example of drugs: Lidocaine

Question 11. Discuss in detail about infraorbital nerve block. Write its landmarks, technique, and complications.
Answer:’

Nerve of Anaesthesize:

  • Infraorbital nerve
  • Inferior palpebral
  • Super labial

Areas of Anaesthesized:

  • Maxillary incisors, canines
  • Underlying periosteum
  • Side of nose Upper lip Lower eyelid

Landmarks of Anaesthesized:

  • Mucobuccal fold
  • Infraorbital notch Infraorbital foramen

The technique of Anaesthesized:

  • Position the patient
  • The maxillary occlusal plane must be parallel to the floor
  • Palpate infraorbital foramen, below the infraorbital ridge
  • Below feel the depression
  • Simultaneously retract the upper lip
  • Insert a 15/8 inch 25 gauge needle by either placing the
    needle parallel to incisors or bisecting
  • Slowly deposit the solution
  • Positive Aspiration: 0.79%

Complications of Anaesthesized:

  • Hematoma may develop across the lower eyelid and the tissues between it and the infraorbital foramen
  • It is a very rare complication

Question 12. Write nerve supply to maxillary teeth.
Answer:

Nerve Supply To Maxillary Teeth:

Clinical Topics Nerve Supply To Maxillary Teeth

Symptoms of Maxillary Teeth:

  • Subjective: No subjective symptoms
  • Objective: Instrumentation demonstrates the absence of pain

Complications of Maxillary Teeth:

  • Hematoma
  • Produces by inserting the needle too far posteriorly Into the pterygoid plexus
  • Varying degrees of mandibular anesthesia
  • Produces due to deposition of solution lateral to the desired location

Question 13. Explain In detail the theories and mechanism of action of local anesthesia.
Or
Theories of local anesthetic action
Answer:

 Theories of local anesthesia:

  1. Acetylcholine theory:
    • States that besides being a neurotransmitter, it helps the inaction of local anesthetic agent
    • It has not proved yet
  2. Calcium displacement theory:
    • States that calcium displaces sodium ions from the receptor site
    • But when demonstrated in calcium baths gave false results
  3. Surface charge theory:
    • States that the LA agent binds to the ions on the membrane surface & causes a change in electric potential
    • But action of
    • LA occurs inside the membrane rather than outside
  4. Membrane expansion theory:
    • LA agents enter the membrane & bind to the hydrophobic groups of the membrane & expand it
    • Accepted one
  5. Specific receptor theory:
    • LA binds to the specific receptors present over the sodium channels

Clinical Topics Membrane Expansion Theory

Mechanism Of Action:

  • Displacement of calcium ions from sodium channel receptor site which permits
  • The binding of the LA molecule to this site produces
  • Blockade of the sodium channel & a
  • Decrease in sodium conductance, which leads to
  • Depression of rate of electrical depolarization Failure to achieve the threshold potential level along- with a
  • Lack of development of propagated action potential which is called
  • Conduction blockade

Clinical Topics Short Essays

Question 1. Classification & indications of corticosteroids.
Answer:

Classification of corticosterolds:

  1. Short Acting:
    • Cortisone
    • Hydrocortisone
  2. Intermediate Acting:
    • Prednisolone
    • Methylprednisolone
  3. Long Acting:
    • Paramethasone
    • Dexamethasone

Indications of corticosterolds:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Eye diseases
  • Bronchial asthma
  • Collagen diseases
  • GIT diseases
  • Renal diseases
  • Organ transplantation
  • Lung diseases
  • Malignancies
  • Allergic diseases
  • Skin diseases

Question 2. Gow gates technique.
Answer:

Nerves To Be Anaesthesized:

  • Inferior alveolar nerve
  • Mental
  • Incisive
  • Lingual
  • Mylohyoid
  • Buccal
  • Auriculotemporal

Areas To Be Anaesthesized:

  • All mandibular teeth & its associated parts

Landmarks Anaesthesized:

  • Extraoral:
    • Corner of mouth
    • Intertragic notch
  • Intraoral:
    • Coronoid process
    • Maxillary occlusal plane

Technique of Anaesthesized: 

  • Locate intraoral & extraoral landmarks
  • Make the patient open his mouth widely
  • Insert needle such that it coincides with extraoral & intraoral landmarks
  • The depth of penetration of the needle is increased by at least 3/4th of its length
  • Aspirate
  • Slowly deposit the solution

Symptoms of Anaesthesized:

  • Subjective
  • Tingling & numbness in the area
  • Objective
  • Instrumentation demonstrates the absence of pain

Question 3. Cephalosporins.
Answer:

Cephalosporins

  • Group of semisynthetic antibiotics

Mechanism of Cephalosporins:

  • Bactericidal
  • Inhibits cell wall synthesis by inhibiting transpeptidase enzyme

Generations of Cephalosporins:

  • 1st generation
    • High activity against gram-positive
  • 2nd Generation
    • High activity against gram-negative
  • 3rdGeneration
    • More active against gram-negative
  • 4th Generation
    • Effective against gram-positive & gram-negative

Uses of Cephalosporin:

  • Dental infections
  • Prophylaxis
  • Respiratory infections
  • UTI
  • Septicaemia
  • Typhoid
  • Nosocomial infection

Adverse Reactions of Cephalosporin:

  • Pain after injection
  • Diarrhea
  • Nephrotoxicity
  • Bleeding
  • Low WBC count
  • Disulfiram-like reaction with alcohol

Question 4. Electrophysiology of nerve conduction.

Answer:

Step 1: Excitation

  1. Initially Slow depolarization:
    • Interior of the membrane becomes less negative than the outside
  2.  The rapid phase of depolarization:
    • Also called Threshold potential/firing potential
  3. Reversal of potential:
    • Interior becomes more positive i.e. + 40 mV

Step 2: Repolarization outside:

  • The interior of the membrane becomes more negative than
  • Upto resting potential reaches 70 mV’

Clinical Topics Repolarization

Question 5. Metabolism of local anesthesia.
Answer:

Metabolism of local anesthesia

Clinical Topics Metabolism Of local Anaesthesia

Question 6. Forcep design.
Answer:

Forcep design:

  • Forcep is designed in such a way that it delivers teeth from the socket
  • Parts: HBeaks, Joint & Handles
  • Cross-hatching on handles is present for grip overhand
  • Serrations are present interiorly to obtain a grip over the tooth
  • Beaks are pushed apically to form a grip

Types of Forcep design:

Type 1:

  •  Mandibular forceps:
    • Beaks are at a right angle to the handles
  • Maxillary forceps:
    • The beaks are in the same line as the handles

Type 2:

  • American forceps:
    • The Joint is designed in a horizontal pattern Used for upper extractions
  • English type:
    • Joint present in a vertical pattern
    • Used for lower extractions

Question 7. Role of vasoconstrictors in local anesthetics.
Answer:

Role of vasoconstrictors in local anesthetics

  • Actions of vasoconstrictor in local anesthesia.
  • By constricting blood vessels, vasoconstrictors decrease blood flow to the site of drug administration.
  • Absorption of local anesthetic into the cardiovascular system is slowed resulting in lower anesthetic blood levels.
  • Decreases the risk of local anesthetic toxicity.
  • Increases duration of action of local anesthetics.
  • Decreases bleeding at the site of administration.

Question 8. Ester group of local anesthetic agents.
Answer:

1. Esters of benzoic acids:

  • Butacaine
  • Cocaine
  • Hexylcaine
  • Tetracaine.

2. Esters of para-amino acids.

  • Chloroquine
  • Procaine.

Metabolism of benzoic acids:

  • Metabolized by hydrolysis by plasma pseudo-choli-esterase
  • The end product of it is PABA
  • If the patient is allergic to it alternative drug is used
  • Example: Coccaine, procaine, etc.

Clinical Topics Short Question And Answers

Question 1. Eutectic mixture of local anesthesia.
Answer:

Eutectic mixture of local anesthesia

  • Topical application of anesthesia
  • Contains 2.5% prilocaine & 2.5% lignocaine

Uses of local anesthesia:

  • Needle phobic patients
  • Painful superficial procedures
  • Circumcision
  • Leg ulcer debridement
  • Gynecological procedures

Contraindications of local anesthesia:

  • Methemoglobinaemia
  • Infants of less than 12 months may lead to methemoglobinemia

Question 2. Adrenaline.
Answer:

Mode of Action: On α & β adrenergic receptors

Actions:

  • ↑ Systolic & diastolic pressure
  • ↑ Cardiac output
  • ↑ Stroke volume
  • ↑ Heart rate
  • ↑ Contraction
  • ↑ Myocardial oxygen consumption

ADR: Bronchodilation

  • Anxiety
  • Dizziness
  • Headache
  • Tremors
  • Weakness

Uses of Adrenaline: Allergic reactions

  • ↑Depth of anesthesia
  • ↑Duration of anesthesia
  • Bronchospasm
  • Cardiac arrest
  • Hemostasis

Question 3. Bupivacaine.
Answer:

Bupivacaine

  • Classification: Amide
  • Potency: 4 times of lignocaine
  • Metabolism: Hepatic amidase
  • PKA: 8.1
  • pH of plain solution: 4.5-6 pH of
  • Vasoconstrictor: 3-4.5
  • Plasma Half-Life: 2.7 hours
  • Effective Concentration: 0.5%
  • Maximum Recommended Dose: 1.3 mg/kg body weight

Question 4. Inferior alveolar nerve block complication.
Answer:

Inferior alveolar nerve block complication

  • Transient facial nerve paralysis: If the needle is inserted into the parotid capsule
  • Trismus: Due to spasm of medial pterygoid muscle
  • Hematoma: Due to injury to vessels

Question 5. Landmarks for extraoral maxillary nerve block.
Answer:

Landmarks for extraoral maxillary nerve block

  • The lower border of the zygomatic arch
  • Coronoid process of mandible
  • Sigmoid notch
  • Lateral pterygoid plate

Question 6. Vasoconstrictor./ Use of vasoconstrictor in local anesthesia.
Answer:

Use of vasoconstrictor in local anesthesia

  • Actions of Vasoconstrictor in local anesthesia
  • By constricting blood vessels, vasoconstrictors decrease blood flow to the site of drug administration
  • Absorption of the local anesthetic into the cardiovascular system is slowed resulting in lower anesthetic blood levels
  • Decreases the risk of local anesthetic toxicity Increases duration of action of local anesthetics
  • Decreases bleeding at the site of administration

Question 7. Posterior superior alveolar nerve block.
Answer:

The technique of nerve block:

  • Position the patient
  • Area of insertion- Height of mesiobuccal fold above the maxillary second molar
  • Retract the patient’s cheek.
  • Insert a 27-gauge needle into the height of the mesiobuccal fold over the second molar
  • Advance the needle slowly in an upward, inward, and backward direction
  • Advance the needle to the desired depth Aspirate in two planes
  • Slowly deposit 0.9-1.8 ml of anesthetic solution Slowly withdraw the needle

Clinical Topics Viva Voce

  1. The posterior portion of the hard palate and overlying structures upto the first premolar on the injected side are anesthetized by greater palatine nerve block
  2. A decrease in interstitial fluid pH will decrease the effectiveness of a local anesthetic block
  3. Epinephrine is added to local anesthetics because it decreases the rate of absorption of the local anesthetic at the injection site
  4. The maxillary branch of the trigeminal nerve passes through the foramen rotundum
  5. A nerve is refractory during depolarization
  6. The local anesthetics act on the nerve membrane
  7. Tachyphylaxis occurs due to repeated use of local anesthesia
  8. Local anesthetics are excreted through the kidneys
  9. The rebound phenomenon is most commonly seen with the use of epinephrine
  10. Bupivacaine is the least toxic local anesthetic
  11. Bupivacaine is a long-acting local anesthetic agent
  12. Local infiltration should be para periosteal
  13. In greater palatine nerve block needle should be perpendicular to the mucosa
  14. Gow Gates technique is for mandibular nerve block
  15. The target of the Gow Gates technique is the neck of the condyle
  16. For extraoral maxillary nerve block, the target area is anterior to lateral pterygoid plate
  17. Aspiration should be done in at least two planes
  18. Local anesthetics produce anesthesia by inhibiting the influx of sodium ions through the nerve membrane
  19. The most potent vasodilator local anesthetic agent is procaine
  20. Amide type of local anesthetic agents undergo biotransformation primarily in the liver
  21. Infiltration in the maxillary first molar region is not effective due to zygomatic buttress bone in the region
  22. The most common complication after surgical removal of a mandibular tooth is